NPIMap

Organization Active NPI

Commonwealth of Massachusetts-DMH

  • Case Management Agency
  • Brockton, MA
National Provider Identifier
1821117359
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
License
EXEMPT Issued in MA
Legal business name
COMMONWEALTH OF MASSACHUSETTS-DMH
Practice address
165 Quincy St
Brockton, MA 02302-2988
Phone
(508) 897-2000
NPI assigned
Mar 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Richard Jobin
Title
Site Director
Phone
(508) 897-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X EXEMPT MA Primary

Addresses

Primary practice location

165 Quincy St
Brockton, MA 02302-2988

Mailing address

25 Staniford St
Boston, MA 02114-2503
Phone (617) 626-8000

Other identifiers 1

IdentifierTypeStateIssuer
1802143MedicaidMA

Other names 1

  • Brockton Multi Service Center Case Mgmt 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

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821117359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 STANIFORD ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142503",
            "telephone_number": "617-626-8000"
        },
        {
            "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": "508-897-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF MASSACHUSETTS-DMH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOBIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "SITE DIRECTOR",
        "authorized_official_telephone_number": "508-897-2000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MA",
            "license": "EXEMPT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1802143",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brockton Multi Service Center Case Mgmt",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.