NPIMap

Organization Active NPI

Commonwealth of Massachusetts-DMH

  • Case Management Agency
  • Quincy, MA
National Provider Identifier
1295855856
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
COMMONWEALTH OF MASSACHUSETTS-DMH
Practice address
460 Quincy Ave
Quincy, MA 02169-8130
Phone
(617) 626-9018
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2007

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

Authorized official

Name
Sharon Cole
Title
Site Director
Phone
(617) 626-9023

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

460 Quincy Ave
Quincy, MA 02169-8130

Mailing address

460 Quincy Ave
Quincy, MA 02169-8130
Phone (617) 626-9018

Other identifiers 1

IdentifierTypeStateIssuer
1802402MedicaidMA

Other names 1

  • SOUTH SUBURBAN SITE 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

Locations

460 Quincy Ave
Quincy, MA 02169
Phone (617) 770-4000

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188172800000",
    "number": "1295855856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 QUINCY AVE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021698130",
            "telephone_number": "617-626-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 QUINCY AVE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021698130",
            "telephone_number": "617-626-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF MASSACHUSETTS-DMH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-08-27",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "SITE DIRECTOR",
        "authorized_official_telephone_number": "617-626-9023"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1802402",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH SUBURBAN SITE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 27, 2007; 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.