Organization
THE COMMONWEALTH OF MASSACHUSETTS
Active
Other names
Brockton Multi Service center
Organization subpart
No
Provider details
NPI number
Authorized official
MONA MACKINNON (CENTER DIRECTOR)
(774) 297-3246
Entity
Organization
Contact information
Practice address
165 QUINCY ST, BROCKTON, MA 02302-2988
(508) 897-2069
Mailing address
165 QUINCY ST, BROCKTON, MA 02302-2988
(508) 897-2069
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
MA
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1305565
—
MA
01
—
2155167
PK
—
Enumeration date
08/24/2006
Last updated
05/03/2023
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