Organization
VA MEDICAL CENTER BROCKTON MA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK BAUER (PROGRAM DIRECTOR)
(774) 826-2456
Entity
Organization
Contact information
Practice address
25 BELMONT CT APT 8, BROCKTON, MA 02301-4730
(774) 826-2456
Mailing address
25 BELMONT CT APT 8, BROCKTON, MA 02301-4730
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
233250
MA
Other
Enumeration date
10/03/2008
Last updated
10/03/2008
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