NPIMap

Organization Active NPI

Department of Mental Health

  • Mental Illness Community Based Residential Treatment Facility
  • Boston, MA
National Provider Identifier
1083732168
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
DEPARTMENT OF MENTAL HEALTH
Practice address
Boston University - Fuller Irtp
85 E Newton St FL 6
Boston, MA 02118-2340
Phone
(617) 414-2005
Fax
(617) 414-2101
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Paul Scopa
Title
Asst Director of Non-Inst Reimburse
Phone
(617) 886-8089

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

Boston University - Fuller Irtp
85 E Newton St FL 6
Boston, MA 02118-2340

Mailing address

25 Staniford St
Boston, MA 02114-2503
Phone (617) 626-8040

Other identifiers 1

IdentifierTypeStateIssuer
1103148MedicaidMA

Other names 1

  • B U Fuller IRTP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
C Stanley Raymond146 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083732168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 STANIFORD ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142503",
            "telephone_number": "617-626-8040",
            "fax_number": "617-626-8295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BOSTON UNIVERSITY - FULLER IRTP",
            "address_2": "85 E NEWTON ST FL 6",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182340",
            "telephone_number": "617-414-2005",
            "fax_number": "617-414-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCOPA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "ASST DIRECTOR OF NON-INST REIMBURSE",
        "authorized_official_telephone_number": "617-886-8089",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1103148",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "B U Fuller IRTP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.