| Brightside Inc | |
|
1233 Main St Holyoke MA 01040 | |
| (413) 536-5111 | |
| Not Available |
| Full Name | Brightside Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1233 Main St, Holyoke, Massachusetts |
| Authorized Official Name and Position | James M Harris (REGIONAL DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Contact | 8607144396 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brightside Inc 1233 Main St Holyoke MA 01040-5381 Ph: (413) 536-5111 | Brightside Inc 1233 Main St Holyoke MA 01040 Ph: (413) 536-5111 |
| NPI Number | 1093709370 |
|---|---|
| Provider Enumeration Date | 09/01/2005 |
| Last Update Date | 04/12/2019 |
| Medicare PECOS PAC ID | 9436134442 |
|---|---|
| Medicare Enrollment ID | O20040623000664 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093709370 | NPI | - | NPPES |
| 110027950A | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 4257 (Massachusetts) | Primary |
| Provider Name | Mary C Tarail |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366493082 PECOS PAC ID: 7315039468 Enrollment ID: I20070822000421 |
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