NPIMap

Organization Active NPI

Cushing Manor

  • Mental Illness Community Based Residential Treatment Facility
  • Dorchester, MA
National Provider Identifier
1487796488
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
CUSHING MANOR
Practice address
20 Cushing Ave
Dorchester, MA 02125-2027
Phone
(617) 288-0400
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Fred D Wright, MPH
Title
President
Phone
(617) 288-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X MA Primary

Addresses

Primary practice location

20 Cushing Ave
Dorchester, MA 02125-2027

Mailing address

20 Cushing Ave
Dorchester, MA 02125-2027
Phone (617) 288-0400

Other identifiers 1

IdentifierTypeStateIssuer
5507995MedicaidMA

National Provider Directory

National Provider Directory

Locations

20 Cushing Ave
Dorchester, MA 02125
Phone (617) 288-0400

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1487796488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CUSHING AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252027",
            "telephone_number": "617-288-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CUSHING AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252027",
            "telephone_number": "617-288-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSHING MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-288-0400",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5507995",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.