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165 Quincy St Brockton MA 02302-2988 | |
| (508) 897-2100 | |
| (508) 586-5117 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 165 Quincy St, Brockton, Massachusetts |
| Authorized Official Name and Position | Claudette G Timas (HUMAN SERVICES COORDINATOR) |
| Authorized Official Contact | 5088972100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
165 Quincy St Brockton MA 02302-2988 Ph: (508) 897-2100 | 165 Quincy St Brockton MA 02302-2988 Ph: (508) 897-2100 |
| NPI Number | 1295020444 |
|---|---|
| Provider Enumeration Date | 06/16/2011 |
| Last Update Date | 06/16/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295020444 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 7686 (Massachusetts) | Primary |
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