NPI 1144768045

Commonwealth of Massachusetts

Organisation Mental Illness Community Based Residential Treatment Facility Brockton, MA

Practice location

Address: 165 Quincy St, Brockton, MA 02302-2988
Phone: (508) 897-2100
Fax: (508) 586-5117
Mailing address: 165 Quincy St., Brockton, MA 02301

Authorised official

Name: Merleen Mills
Title: Dirtector of Emergency Services
Phone: (508) 285-9400

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence LN25249 (MA)

Other Community Based Residential Treatment Facility, Mental Illness providers in Massachusetts →

Registry record

NPI: 1144768045
Entity type: Organization
NPI issued: 10 Feb 2017
Record last updated: 10 Feb 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.