Organization
THE MERCY HOSPITAL INC
Active
Other names
PROVIDENCE BEHAVIORAL HEALTH HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES M HARRIS (REGIONAL DIRECTOR OF REIMBURSEMENT)
(860) 714-4396
Entity
Organization
Contact information
Practice address
1233 MAIN ST, HOLYOKE, MA 01040
(413) 536-5111
Mailing address
1233 MAIN ST, HOLYOKE, MA 01040-5381
(413) 536-5111
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
628
MA
282N00000X
General Acute Care Hospital
35
MA
283Q00000X
Psychiatric Hospital
Primary
628
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110027346C
—
MA
05
—
110027346D
—
MA
05
—
110027346F
—
MA
01
—
2222002305
BLUE CROSS OF MASS INPT
MA
01
—
2222002325
BLUE CROSS OF MASS OUTPT
MA
01
—
2222002330
BLUE CROSS OF MASS OP SUR
MA
05
—
3032125
—
CT
05
—
9105905
—
FL
Enumeration date
09/01/2005
Last updated
12/18/2019
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