Organization
GANDARA MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONEL LASANTA (CLINICIAN)
(413) 846-0445
Entity
Organization
Contact information
Practice address
120 MAPLE ST, SPRINGFIELD, MA 01103-2203
(413) 846-0445
Mailing address
120 MAPLE ST, SPRINGFIELD, MA 01103-2203
(413) 846-0445
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134107113
NHP
MA
01
—
12529
HNE
MA
05
—
1307576
—
MA
01
—
71756
TUFTS
MA
01
—
997303
NETWORK HEALTH
MA
Enumeration date
11/29/2016
Last updated
11/29/2016
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