Provider Demographics
NPI:1043306038
Name:BIOBEHAVIORAL SCIENCES, INC.
Entity Type:Organization
Organization Name:BIOBEHAVIORAL SCIENCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:DELL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:617-236-7711
Mailing Address - Street 1:PO BOX 15712
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-236-7711
Mailing Address - Fax:617-236-7712
Practice Address - Street 1:60 CHARLESGATE W
Practice Address - Street 2:SUITE 1C
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-2130
Practice Address - Country:US
Practice Address - Phone:617-236-7711
Practice Address - Fax:617-236-7712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW10159Medicare ID - Type Unspecified