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Organization
FBTC TRANSITIONAL SUB, LLC
Active
Organization
FBTC TRANSITIONAL SUB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PATRICIA RODENBERG-ROBERTS (VP& SR ASST GENERAL COUNSEL)
(952) 836-2234
Entity
Organization
Contact information
Practice address
55 TOZER RD, BEVERLY, MA 01915-5515
(978) 969-2894
Mailing address
55 TOZER RD, BEVERLY, MA 01915-5515
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QH0700X
Hearing and Speech Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110078808A
—
MA
Enumeration date
03/23/2021
Last updated
03/29/2025
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