| Elite Behavioral Services Inc | |
|
27 Ridgecrest Terrae #14b Boston MA 02132 | |
| (617) 460-3079 | |
| Not Available |
| Full Name | Elite Behavioral Services Inc |
|---|---|
| Speciality | Counselor |
| Location | 27 Ridgecrest Terrae #14b, Boston, Massachusetts |
| Authorized Official Name and Position | James M Smith (CEO) |
| Authorized Official Contact | 6174603079 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Behavioral Services Inc 1834 Centre St #547 Boston MA 02132 Ph: (617) 460-3079 | Elite Behavioral Services Inc 27 Ridgecrest Terrae #14b Boston MA 02132 Ph: (617) 460-3079 |
| NPI Number | 1528778180 |
|---|---|
| Provider Enumeration Date | 12/05/2022 |
| Last Update Date | 12/05/2022 |
| Certification Date | 12/05/2022 |
| Medicare PECOS PAC ID | 8426490319 |
|---|---|
| Medicare Enrollment ID | O20240523001323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528778180 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | James Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851714653 PECOS PAC ID: 3577901792 Enrollment ID: I20240409000189 |
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