NPI 1588093108

South Bay Mental Health

Organisation Exclusive Provider Organization Brockton, MA

Practice location

Address: 1115 W Chestnut St, Brockton, MA 02301-7501
Phone: (508) 580-4691

Authorised official

Name: Shawntae Nicole Grace
Title: Intake Liason
Phone: (508) 863-1584

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

Other Exclusive Provider Organization providers in Massachusetts →

Registry record

NPI: 1588093108
Entity type: Organization
NPI issued: 4 Nov 2013
Record last updated: 4 Nov 2013

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.