NPI 1710004320
Department of Mental Health
Practice location
- Address
- Tewksbury State Hosp Special Bldg - Merrimack Ctr Birtp 365 East St, Tewksbury, MA 01876
- Phone
- (978) 858-3776
- Fax
- (978) 858-3494
- Mailing address
- 25 Staniford St, Boston, MA 02114-2503
Authorised official
- Name
- Paul Scopa
- Title
- Asst. Director of Non-Inst Reimburs
- Phone
- (617) 886-8089
Registered specialties
Mental Illness Community Based Residential Treatment Facility
Primary
Registry record
- NPI
- 1710004320
- Entity type
- Organization
- NPI issued
- 26 Mar 2007
- Record last updated
- 22 Aug 2020
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.