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CUSHING MANOR NPI 1487796488


NPI Information

NPI: 1487796488
Provider Name: CUSHING MANOR
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
20 CUSHING AVE
DORCHESTER, MA
ZIP 02125
Phone: (617) 288-0400
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CUSHING MANOR is a community based residential treatment facility mental illness in Dorchester, MA. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. CUSHING MANOR NPI is 1487796488. The provider is registered as an organization entity type.

The provider's business location address is:

20 CUSHING AVE
DORCHESTER, MA
ZIP 02125-027
Phone: (617) 288-0400

The provider's authorized official is Fred D Wright .
The authorized official title is President and has the following contact phone number (617) 288-0400.

The enumeration date for this NPI number is 2/13/2007 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320800000XCommunity Based Residential Treatment Facility, Mental IllnessMASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15507995MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.