Organization
SOMERVILLE MENTAL HEALTH ASSOCIATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARITZA E JACOBS (DIRECTOR OF MANAGAEMENT SERVICES)
(617) 629-5341
Entity
Organization
Contact information
Practice address
78 COLLEGE AVE, SOMERVILLE, MA 02144-1916
(617) 629-6624
(617) 625-6339
Mailing address
167 HOLLAND ST, ROOM 133, SOMERVILLE, MA 02144
(617) 625-0710
(617) 625-6339
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1305727
—
MA
Enumeration date
04/01/2008
Last updated
04/01/2008
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