Organization
BAY STATE COUNSELING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YANANTS ANTONEVICH MD (DIRECTOR)
(508) 857-1466
Entity
Organization
Contact information
Practice address
1717 MAIN ST, R, BROCKTON, MA 02301-7134
(508) 857-1466
(508) 857-1725
Mailing address
1717-R MAIN STREET, BROCKTON, MA 02301-7134
(508) 857-1466
(508) 857-1725
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/16/2011
Last updated
08/16/2011
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