Organization
SOUTH BAY MENTAL HEALTH CENTER, INC.
Active
Other names
South Bay Community Services
Organization subpart
No
Provider details
NPI number
Authorized official
SARA J HART LMHC (PRESIDENT/COO)
(508) 324-0328
Entity
Organization
Contact information
Practice address
1115 WEST CHESTNUT STREET, SUITE 202, BROCKTON, MA 02301
(508) 521-2200
(508) 584-2227
Mailing address
1115 WEST CHESTNUT STREET, SUITE 202, BROCKTON, MA 02301
(508) 521-2200
(508) 584-2227
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
4222
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1300423
—
MA
05
—
1309056
—
MA
05
—
1309137
—
MA
05
—
1309196
—
MA
05
—
1309218
—
MA
05
—
1309226
—
MA
05
—
1309994
—
MA
05
—
1310003
—
MA
05
—
1310976
—
MA
05
—
1311093
—
MA
05
—
1311964
—
MA
05
—
1312065
—
MA
05
—
1312472
—
MA
05
—
1316478
—
MA
05
—
1319779
—
MA
Enumeration date
01/03/2006
Last updated
04/01/2019
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