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Organization
MINDCARE AGENCY PC
Active
Organization
MINDCARE AGENCY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR FARUK MD (CEO)
(413) 271-7136
Entity
Organization
Contact information
Practice address
125 LIBERTY ST, SUITE 205, SPRINGFIELD, MA 01103-1114
(413) 271-7136
(413) 271-7137
Mailing address
125 LIBERTY ST, SUITE 205, SPRINGFIELD, MA 01103-1114
(413) 271-7136
(413) 271-7137
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
223674
MA
251S00000X
Community/Behavioral Health Agency
—
NULL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NULL
Other
Enumeration date
09/03/2015
Last updated
11/18/2019
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