NPIMap

Organization Active NPI

The Commonwealth of Massachusetts

Doing business as Brockton Multi Service center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brockton, MA
National Provider Identifier
1326155458
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
THE COMMONWEALTH OF MASSACHUSETTS
Doing business as
Brockton Multi Service center
Practice address
165 Quincy St
Brockton, MA 02302-2988
Phone
(508) 897-2069
NPI assigned
Aug 24, 2006
Last updated
May 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Authorized official

Name
Mona Mackinnon
Title
Center Director
Phone
(774) 297-3246

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X MA Primary
Pharmacy 333600000X
Clinic Pharmacy 3336C0002X

Addresses

Primary practice location

165 Quincy St
Brockton, MA 02302-2988

Mailing address

165 Quincy St
Brockton, MA 02302-2988
Phone (508) 897-2069

Other names 1

  • Brockton Multi Service center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050203000148 MA Part B Supplier - Clinic/Group Practice 8820906860 Receives reassigned benefits from 23 practitioners
Practice locations: Brockton, MA; Norton, MA; Plymouth, MA

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Quincy Mental Health Center147 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

108 W Main St
Ste 2
Norton, MA 02766

Ownership & related parties

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tewksbury HospitalTewksbury, MA, CCN 222003 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1966
Lemuel Shattuck HospitalJamaica Plain, MA, CCN 222006 Hospital Operational/Managerial Control (100%) Jul 1, 1966
Dr. John C Corrigan Mental Health CenterFall River, MA, CCN 224028 Hospital 5% Or Greater Direct Ownership Interest (100%) Feb 2, 1989
Solomon Carter Fuller Mental Health CenterBoston, MA, CCN 224040 Hospital Operational/Managerial Control (100%) Dec 26, 2008
Worcester Recovery Center and HospitalWorcester, MA, CCN 224032 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 17, 1992
Cape Cod and the Islands Mental Health CenterPocasset, MA, CCN 224031 Hospital 5% Or Greater Direct Ownership Interest (100%) Feb 2, 1989
Taunton State HospitalTaunton, MA, CCN 224001 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1986
Massachusetts Veterans' Home in ChelseaChelsea, MA, CCN 225110 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Mar 1, 2023
Jul 1, 1966
Massachusetts Veterans' Home of HolyokeHolyoke, MA, CCN 225786 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 May 6, 2025
May 6, 2025

Owned or controlled facilities with NPI records 11

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 44

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.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683072000000",
    "number": "1326155458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 QUINCY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022988",
            "telephone_number": "508-897-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 QUINCY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022988",
            "telephone_number": "508-897-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE COMMONWEALTH OF MASSACHUSETTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "MACKINNON",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "CENTER DIRECTOR",
        "authorized_official_telephone_number": "774-297-3246"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MA",
            "license": null,
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brockton Multi Service center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brockton Multi Service center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.