Organization Active NPI

Commonwealth Behavioral Health LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Dedham, MA
National Provider Identifier
1992418099
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
COMMONWEALTH BEHAVIORAL HEALTH LLC
Doing business as
New Harbor Behavioral Healthcare
Practice address
105 Eastern Ave Ste 216
Dedham, MA 02026-4555
Phone
(617) 529-8216
NPI assigned
Jan 4, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Authorized official

Name
Eric Dyer
Title
Ceo
Phone
(617) 529-8216

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

105 Eastern Ave Ste 216
Dedham, MA 02026-4555

Mailing address

105 Eastern Ave Ste 216
Dedham, MA 02026-4555
Phone (617) 529-8216

Other names 1

  • New Harbor Behavioral Healthcare Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2284243Commonwealth Behavioral Health, LLC105 Eastern Ave, Dedham, MA 02026Certificate of waiverJun 19, 2027

National Provider Directory

National Provider Directory

Locations

105 Eastern Ave
Ste 216
Dedham, MA 02026
Phone (617) 529-8216

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1992418099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 EASTERN AVE STE 216",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264555",
            "telephone_number": "617-529-8216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 EASTERN AVE STE 216",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020264555",
            "telephone_number": "617-529-8216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "DYER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-529-8216"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Harbor Behavioral Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dedham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.