| Massachusetts Mentor Llc | |
|
280 Bridge St Suite 230 Dedham MA 02026-1759 | |
| (781) 326-4207 | |
| (781) 326-4654 |
| Full Name | Massachusetts Mentor Llc |
|---|---|
| Speciality | Foster Care Agency |
| Location | 280 Bridge St, Dedham, Massachusetts |
| Authorized Official Name and Position | Mary Patricia Rodenberg-roberts (VP & SR. ASST GENERAL COUNSEL) |
| Authorized Official Contact | 9528362234 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Massachusetts Mentor Llc 280 Bridge St Suite 230 Dedham MA 02026-1759 Ph: (781) 326-4207 | Massachusetts Mentor Llc 280 Bridge St Suite 230 Dedham MA 02026-1759 Ph: (781) 326-4207 |
| NPI Number | 1811021090 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 05/08/2024 |
| Certification Date | 05/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811021090 | NPI | - | NPPES |
| 1904469 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1615 (Massachusetts) | Secondary |
| 253J00000X | Foster Care Agency | (* (Not Available)) | Primary |
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