Basic Information
| Provider Information | |||||||||
| NPI: | 1467707844 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUTH BAY MENTAL HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 70 HAMPSTEAD RD | ||||||||
| Address2: | |||||||||
| City: | SANDOWN | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038732413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035051965 | ||||||||
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| Practice Location | |||||||||
| Address1: | 15 UNION ST | ||||||||
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| City: | LAWRENCE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018401866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6035051965 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2012 | ||||||||
| LastUpdateDate: | 07/21/2012 | ||||||||
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| AuthorizedOfficialLastName: | LEHMANN | ||||||||
| AuthorizedOfficialFirstName: | KRISTINA | ||||||||
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| AuthorizedOfficialTitleorPosition: | SITE SUPERVISOR | ||||||||
| AuthorizedOfficialTelephone: | 9786884830 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | NH | Y | Agencies | Community/Behavioral Health |
No ID Information.