NPIMap

Organization Active NPI

The Commonwealth of Massachusetts

Doing business as Quincy Mental Health Center

  • Psychiatric Hospital
  • Quincy, MA
National Provider Identifier
1407884059
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
THE COMMONWEALTH OF MASSACHUSETTS
Doing business as
Quincy Mental Health Center
Practice address
460 Quincy Ave
Quincy, MA 02169-8130
Phone
(617) 626-9002
Fax
(617) 770-2953
NPI assigned
Jun 30, 2006
Last updated
Aug 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Authorized official

Name
Susan Wing
Title
NE/Suburban Area Director
Phone
(508) 616-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

460 Quincy Ave
Quincy, MA 02169-8130

Mailing address

167 Lyman St
Westborough, MA 01581-2619
Phone (508) 616-3500

Other identifiers 1

IdentifierTypeStateIssuer
1102699MedicaidMA

Other names 1

  • Quincy Mental Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407884059. Details of each certification follow.

Hospital certification: CCN 224025

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
QUINCY MENTAL HEALTH CENTER
Certification status
Terminated Voluntary: merger or closure, Nov 1, 2009
Provider type (POS)
Hospital – Psychiatric
Participating since
Feb 19, 1987
Last certification
Jan 30, 2008
Beds
16
Ownership / control type
Local
Facility address
460 Quincy Avenue
Quincy, MA 02169

National Provider Directory

National Provider Directory

Locations

167 Lyman St
Westborough, MA 01581
Phone (508) 616-2801

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1407884059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 LYMAN ST",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015812619",
            "telephone_number": "508-616-3500",
            "fax_number": "508-616-2859"
        },
        {
            "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": "617-626-9002",
            "fax_number": "617-770-2953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE COMMONWEALTH OF MASSACHUSETTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "WING",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "NE/SUBURBAN AREA DIRECTOR",
        "authorized_official_telephone_number": "508-616-3500"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1102699",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quincy Mental Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.