Organization
CLINICAL AND SUPPORT OPTIONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIAN E. AUBUCHON (CLINICAL SUPERVISOR)
(413) 586-3757
Entity
Organization
Contact information
Practice address
17 NEW SOUTH ST STE 116, NORTHAMPTON, MA 01060-4075
(415) 582-0471
(413) 582-1807
Mailing address
17 NEW SOUTH STREET SUITE 116, NORTHAMPTON, MA 01060
(413) 566-3757
(413) 582-1807
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1023212
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330402193
BHL
—
Enumeration date
12/04/2009
Last updated
12/24/2009
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