NPIMap

Organization Active NPI

South Shore Family Health Collaborative

  • Community/Behavioral Health Agency
  • Quincy, MA
National Provider Identifier
1154724391
Registry record updated Oct 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1499 Issued in MA
Legal business name
SOUTH SHORE FAMILY HEALTH COLLABORATIVE
Practice address
1212 Hancock St
205
Quincy, MA 02169-4300
Phone
(617) 745-4100
NPI assigned
Oct 2, 2014
Last updated
Oct 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2014

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

Authorized official

Name
Mr. Stephen DuclosNPI 1629166418
Title
Owner
Phone
(617) 745-4100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1499 MA Primary

Addresses

Primary practice location

1212 Hancock St
205
Quincy, MA 02169-4300

Mailing address

1212 Hancock St
205
Quincy, MA 02169-4300
Phone (617) 745-4100

National Provider Directory

National Provider Directory

Locations

1212 Hancock St
Ste 205
Quincy, MA 02169
Phone (617) 657-9793

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1412208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1154724391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 HANCOCK ST",
            "address_2": "205",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694300",
            "telephone_number": "617-745-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 HANCOCK ST",
            "address_2": "205",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021694300",
            "telephone_number": "617-745-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE FAMILY HEALTH COLLABORATIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-02",
        "last_updated": "2014-10-02",
        "status": "A",
        "authorized_official_last_name": "DUCLOS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-745-4100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MA",
            "license": "1499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.