# SOUTH BAY MENTAL HEALTH CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497830905
- **Authorized official:** DR. PETER SCANLON PHD (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (508) 559-0473

## Contact information

- **Practice address:** 37 BELMONT ST, BROCKTON, MA 02301-5299
- **Practice address phone:** (508) 580-4691
- **Mailing address:** 37 BELMONT ST, BROCKTON, MA 02301-5299
- **Mailing address phone:** (508) 580-4691

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 4222 | MA | Yes |

## Other

- **Enumeration date:** 10/25/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CP0064 | NURSE SPECIALIST | MA |