NPIMap

Organization Active NPI

Sport Development Services Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dorchester Center, MA
National Provider Identifier
1811681802
Registry record updated Jun 5, 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
SPORT DEVELOPMENT SERVICES INC.
Practice address
19 Boyden St
Dorchester Center, MA 02124-3212
Phone
(781) 244-0894
NPI assigned
Jun 5, 2023
Last updated
Jun 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Authorized official

Name
Floyd A Williams-AgnewNPI 1508515990
Title
Ceo/President
Phone
(781) 244-0894

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

19 Boyden St
Dorchester Center, MA 02124-3212

Mailing address

300 Main St Unit 121
North Easton, MA 02356-0610

National Provider Directory

National Provider Directory
Tax ID family
Sport Development Services Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

300 Main St
Unit 121
North Easton, MA 02356

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1685923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1811681802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MAIN ST UNIT 121",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023560610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BOYDEN ST",
            "city": "DORCHESTER CENTER",
            "state": "MA",
            "postal_code": "021243212",
            "telephone_number": "781-244-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORT DEVELOPMENT SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-05",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS-AGNEW",
        "authorized_official_first_name": "FLOYD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "781-244-0894"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester Center, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.