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MASSACHUSETTS MENTOR LLC NPI 1811021090


NPI Information

NPI: 1811021090
Provider Name: MASSACHUSETTS MENTOR LLC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
280 BRIDGE ST
SUITE 230
DEDHAM, MA
ZIP 02026
Phone: (781) 326-4207
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MASSACHUSETTS MENTOR LLC is a community behavioral health in Dedham, MA. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. MASSACHUSETTS MENTOR LLC NPI is 1811021090. The provider is registered as an organization entity type.

The provider's business location address is:

280 BRIDGE ST
SUITE 230
DEDHAM, MA
ZIP 02026-759
Phone: (781) 326-4207
Fax: (781) 326-4654

The provider's authorized official is Mary Patricia Rodenberg-roberts .
The authorized official title is Vp & Sr. Asst General Counsel and has the following contact phone number (952) 836-2234.

The enumeration date for this NPI number is 3/16/2007 and was last updated on 4/25/2024.


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
1251S00000XCommunity/Behavioral Health1615MASSACHUSETTSYes

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
11904469MEDICAIDMASSACHUSETTS

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

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