NPIMap

Organization Active NPI

SB Transitional Sub, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brockton, MA
National Provider Identifier
1962091173
Registry record updated Oct 14, 2024
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
SB TRANSITIONAL SUB, LLC
Practice address
1115 W Chestnut St
Brockton, MA 02301-7501
Phone
(508) 521-2200
NPI assigned
Jan 12, 2021
Last updated
Oct 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Authorized official

Name
Mary Patricia Rodenberg-Roberts, M.ED.
Title
VP & Sr. Asst General Counsel
Phone
(952) 836-2234

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1115 W Chestnut St
Brockton, MA 02301-7501

Mailing address

1115 W Chestnut St
Brockton, MA 02301-7501
Phone (508) 521-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210423000601 MA Part B Supplier - Clinic/Group Practice 7911315379 Receives reassigned benefits from 116 practitioners
Practice locations: Leominster, MA; Worcester, MA; Weymouth, MA; Wakefield, MA; Springfield, MA; Salem, MA; Plymouth, MA; Lowell, MA…

National Provider Directory

National Provider Directory
Tax ID family
SB Transitional Sub LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

103 Commercial St
Ste 2
Brockton, MA 02302

280 Bridge St
Ste 110
Dedham, MA 02026
Phone (781) 251-3000

415 Neponset Ave
Ste 3
Dorchester, MA 02122
Phone (857) 217-3700

80 Erdman Way
Ste 208
Leominster, MA 01453
Phone (978) 870-1840

7 Scobee Cir
Plymouth, MA 02360
Phone (978) 216-0410

35 Congress St
Ste 225
Salem, MA 01970
Phone (978) 542-1951

140 High St
Ste 230
Springfield, MA 01199
Phone (413) 495-1500

541 Main St
Ste 303
Weymouth, MA 02190
Phone (781) 801-3255

324 Clark St
Worcester, MA 01606
Phone (508) 752-3969

Practitioners & affiliated clinicians

Practitioners 327

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 327

NPI Registry JSON

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1962091173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 W CHESTNUT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017501",
            "telephone_number": "508-521-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 W CHESTNUT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017501",
            "telephone_number": "508-521-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SB TRANSITIONAL SUB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-12",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "RODENBERG-ROBERTS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "VP & SR. ASST GENERAL COUNSEL",
        "authorized_official_telephone_number": "952-836-2234",
        "authorized_official_credential": "M.ED."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.