Provider Demographics
NPI:1073904140
Name:MHM HEALTH PROFESSIONALS, INC
Entity Type:Organization
Organization Name:MHM HEALTH PROFESSIONALS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STATEWIDE MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:GROBLEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-285-4018
Mailing Address - Street 1:1593 SPRING HILL RD
Mailing Address - Street 2:SUITE 610
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2245
Mailing Address - Country:US
Mailing Address - Phone:703-749-4600
Mailing Address - Fax:
Practice Address - Street 1:HAVARD ROAD
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:MA
Practice Address - Zip Code:01464
Practice Address - Country:US
Practice Address - Phone:978-425-4341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2269378363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty