Monte Nido Massachusetts, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

41YT Issued in MA

Legal business name

MONTE NIDO MASSACHUSETTS, LLC

Doing business as

Eating Disorder Center of Boston

Practice address

419 Boylston St Ste 501B
Boston, MA 02116-3310

Phone

(857) 233-9969

NPI assigned

Aug 10, 2015

Organization subpart

Yes

Parent organization

MONTE NIDO HOLDINGS, LLCAs reported in NPPES

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

Authorized official

Name

Mike Bagley

Title

Chief Financial Officer

Phone

(305) 663-1876

Specialties & licenses 1

Addresses

Other names 1

• Eating Disorder Center of Boston Doing business as

Locations

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

{
    "created_epoch": "1439164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1831575091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 SW 76TH ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435002",
            "telephone_number": "305-663-1876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 BOYLSTON ST STE 501B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021163310",
            "telephone_number": "857-233-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTE NIDO MASSACHUSETTS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONTE NIDO HOLDINGS, LLC",
        "enumeration_date": "2015-08-10",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "BAGLEY",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "305-663-1876"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MA",
            "license": "41YT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eating Disorder Center of Boston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ruben Montano-Lopez, M.A,
• Katherine Montas, LCSW
• Leila Montaser Montaser Kouhsari, M.D., PH.D.
• Kamaneh Montazeri, M.D.
• Caitlin Jeffries Montcrieff, NP
• Mario Ernesto Montealegre Gallegos, MD
• Rafael Montecino, M.D.
• Josie Montegaard, MSN, AGPCNP-BC
• Carla B Monteiro, MSW, LICSW
• Joseph Alexander Monteiro, M.D.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Boston, MA
• Providers in Boston, MA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.