| Dimock Early Intervention | |
|
1800 Columbus Ave Roxbury MA 02119-1042 | |
| (617) 442-8800 | |
| (617) 445-0091 |
| Full Name | Dimock Early Intervention |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1800 Columbus Ave, Roxbury, Massachusetts |
| Authorized Official Name and Position | David Whitham (DIRECTOR IT & AR) |
| Authorized Official Contact | 6174428800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dimock Early Intervention 55 Dimock St Roxbury MA 02119-1029 Ph: (617) 442-8800 | Dimock Early Intervention 1800 Columbus Ave Roxbury MA 02119-1042 Ph: (617) 442-8800 |
| NPI Number | 1174677223 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174677223 | NPI | - | NPPES |
| 1887297 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Massachusetts) | Primary |
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