Organization
GANDARA MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY J EAST-TROU (EXECUTIVE DIRECTOR)
(413) 736-8329
Entity
Organization
Contact information
Practice address
147 NORMAN ST, WEST SPRINGFIELD, MA 01089-5003
(413) 736-8329
Mailing address
147 NORMAN ST, WEST SPRINGFIELD, MA 01089-5003
(413) 736-8329
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1307576
—
MA
01
—
M18463
BLUE CROSS/BLUE SHIELD
—
Enumeration date
01/27/2011
Last updated
01/27/2011
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