Organization
COMMONWEALTH OF MASSCHUSETTS
Active
Other names
Department of Mental Health - Cambridge Somerville Office
Organization subpart
No
Provider details
NPI number
Authorized official
TINA LICCIARDELLO (SITE DIRECTOR)
(617) 626-4800
Entity
Organization
Contact information
Practice address
2400 MASSACHUSETTS AVE, CAMBRIDGE, MA 02140-1854
(617) 626-4800
(617) 497-6128
Mailing address
2400 MASSACHUSETTS AVE, CAMBRIDGE, MA 02140-1854
(617) 626-4800
(617) 497-6128
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1802151
—
MA
Enumeration date
03/23/2007
Last updated
08/22/2020
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