NPIMap

Organization Active NPI

Commonwealth of Mass-DDS

Doing business as Gba Harbor Area Office

  • Case Management Agency
  • Hyde Park, MA
National Provider Identifier
1215068408
Registry record updated Oct 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
COMMONWEALTH OF MASS-DDS
Doing business as
Gba Harbor Area Office
Practice address
65 Sprague St
Hyde Park, MA 02136-2061
Phone
(617) 360-2400
NPI assigned
Mar 8, 2007
Last updated
Oct 1, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2009

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

Authorized official

Name
Jeanette Maillet
Title
Chief Financial Officer
Phone
(617) 727-5608

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU Primary

Addresses

Primary practice location

65 Sprague St
Hyde Park, MA 02136-2061

Mailing address

500 Harrison Ave
Boston, MA 02118-2439
Phone (617) 727-5608

Other identifiers 1

IdentifierTypeStateIssuer
1813013MedicaidMA

Other names 1

  • GBA HARBOR AREA OFFICE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Worcester State147 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

Locations

500 Harrison Ave
Boston, MA 02118
Phone (617) 624-7775

65 Sprague St
Hyde Park, MA 02136
Phone (617) 360-2400

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254355200000",
    "number": "1215068408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HARRISON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182439",
            "telephone_number": "617-727-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 SPRAGUE ST",
            "city": "HYDE PARK",
            "state": "MA",
            "postal_code": "021362061",
            "telephone_number": "617-360-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF MASS-DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2009-10-01",
        "status": "A",
        "authorized_official_last_name": "MAILLET",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "617-727-5608"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1813013",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GBA HARBOR AREA OFFICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hyde Park, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; 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.