Organization
TEEN CHALLENGE NEW ENGLAND INC
Active
Other names
Massachusetts TC Clinical Group
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME POSEY M.ED, LADCI (PROGRAM DIRECTOR)
(617) 792-0581
Entity
Organization
Contact information
Practice address
1311 MAIN ST, BROCKTON, MA 02301-7109
(508) 408-4378
Mailing address
1311 MAIN ST, BROCKTON, MA 02301-7109
(508) 408-4378
(508) 825-3242
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110158884A
—
MA
Enumeration date
12/16/2018
Last updated
12/17/2020
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