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348 North Pearl Street Rm Brockton MA 02301-1197 | |
| (508) 510-5940 | |
| (508) 510-6903 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 348 North Pearl Street, Brockton, Massachusetts |
| Authorized Official Name and Position | Barbara A King (PRESIDENT) |
| Authorized Official Contact | 5085105940 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
348 North Pearl Street Rm 8 Brockton MA 02301-1197 Ph: (508) 510-5940 | 348 North Pearl Street Rm Brockton MA 02301-1197 Ph: (508) 510-5940 |
| NPI Number | 1790189439 |
|---|---|
| Provider Enumeration Date | 10/09/2014 |
| Last Update Date | 04/16/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790189439 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Massachusetts) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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