Provider Demographics
NPI:1093714412
Name:FIRST PSYCHIATRIC PLANNERS, INC
Entity Type:Organization
Organization Name:FIRST PSYCHIATRIC PLANNERS, INC
Other - Org Name:BOURNEWOOD HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:GALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-469-0300
Mailing Address - Street 1:300 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3658
Mailing Address - Country:US
Mailing Address - Phone:617-469-0300
Mailing Address - Fax:617-469-5013
Practice Address - Street 1:300 SOUTH ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02467-3658
Practice Address - Country:US
Practice Address - Phone:617-469-0300
Practice Address - Fax:617-469-5013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA636283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001380OtherVALUEOPTIONS
MA1209027Medicaid
MA996093OtherNETWORK HEALTH PLAN
MA104969OtherMAGELLAN BEHAVIORAL HLTH
MA1000465OtherBEACON HEALTH STRATEGIES
MABOU2222400901OtherBLUE CROSS INPATIENT #
MA906672OtherTUFTS HEALTH PLAN
MABOU2222400910OtherBLUE CROSS OUTPATIENT #
MA1102303Medicaid
MA104969OtherMAGELLAN BEHAVIORAL HLTH