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Organization
THE COMMONWEALTH OF MASSACHUSETTS
Active
Organization
THE COMMONWEALTH OF MASSACHUSETTS
Active
Other names
Brockton Multi Service center
Organization subpart
No
Provider details
NPI number
Authorized official
MONA MACKINNON (CENTER DIRECTOR)
(774) 297-3246
Entity
Organization
Contact information
Practice address
165 QUINCY ST, BROCKTON, MA 02302-2988
(508) 897-2069
Mailing address
165 QUINCY ST, BROCKTON, MA 02302-2988
(508) 897-2069
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
MA
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1305565
—
MA
01
—
2155167
PK
—
Enumeration date
08/24/2006
Last updated
05/03/2023
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