Organization
COMMONWEALTH OF MASSACHUSETTS
Active
Other names
Department of Mental Health - Mass Mental Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA MARSHALL (CENTER DIRECTOR)
(617) 626-9459
Entity
Organization
Contact information
Practice address
75 FENWOOD RD, BOSTON, MA 02115-6103
(617) 626-9459
Mailing address
75 FENWOOD RD, BOSTON, MA 02115-6103
(617) 626-9459
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1310046
—
MA
Enumeration date
03/20/2007
Last updated
10/24/2014
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