| Department Of Mental Health - Mass Mental Health Center | |
|
75 Fenwood Rd Boston MA 02115-6103 | |
| (617) 626-9459 | |
| Not Available |
| Full Name | Department Of Mental Health - Mass Mental Health Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 75 Fenwood Rd, Boston, Massachusetts |
| Authorized Official Name and Position | Regina Marshall (CENTER DIRECTOR) |
| Authorized Official Contact | 6176269459 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Department Of Mental Health - Mass Mental Health Center 75 Fenwood Rd Boston MA 02115-6103 Ph: (617) 626-9459 | Department Of Mental Health - Mass Mental Health Center 75 Fenwood Rd Boston MA 02115-6103 Ph: (617) 626-9459 |
| NPI Number | 1194840975 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 10/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194840975 | NPI | - | NPPES |
| 1310046 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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