NPI 1245364595

Commonwealth of Massachusetts

Organisation Case Management Agency Brockton, MA

Practice location

Address: 60 Main Street 3rd Floor, Brockton, MA 02301
Phone: (508) 427-5731
Fax: (508) 586-9316
Mailing address: 40 Broad Street 4th Floor, Boston, MA 02109

Authorised official

Name: Dylan Lattimore
Title: Deputy Commissioner of Administrat
Phone: (857) 408-0675

Registered specialties

Case Management Agency Primary

Agencies Taxonomy 251B00000X Licence EXAMPT

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Registry record

NPI: 1245364595
Entity type: Organization
NPI issued: 16 Mar 2007
Record last updated: 19 Mar 2026

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.