| Randolph Behavioral Health Services, Inc. | |
|
21 Mazzeo Dr Ste 102 Randolph MA 02368-3448 | |
| (781) 885-7530 | |
| Not Available |
| Full Name | Randolph Behavioral Health Services, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 21 Mazzeo Dr Ste 102, Randolph, Massachusetts |
| Authorized Official Name and Position | Daphne Claudomir (PRESIDENT) |
| Authorized Official Contact | 7818857530 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Randolph Behavioral Health Services, Inc. Po Box 4414 Boynton Beach FL 33424-4414 Ph: (781) 885-7530 | Randolph Behavioral Health Services, Inc. 21 Mazzeo Dr Ste 102 Randolph MA 02368-3448 Ph: (781) 885-7530 |
| NPI Number | 1275079097 |
|---|---|
| Provider Enumeration Date | 01/18/2017 |
| Last Update Date | 05/24/2024 |
| Certification Date | 05/24/2024 |
| Medicare PECOS PAC ID | 9436499944 |
|---|---|
| Medicare Enrollment ID | O20190320001560 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275079097 | NPI | - | NPPES |
| Provider Name | Celestine M Holt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962741009 PECOS PAC ID: 4880831973 Enrollment ID: I20130509000118 |
| Provider Name | Monique N Tucker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821246455 PECOS PAC ID: 4385801521 Enrollment ID: I20190320001783 |
| Provider Name | Daphne Rollande Claudomir |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063714384 PECOS PAC ID: 0244570752 Enrollment ID: I20240111002974 |
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