Provider Demographics
NPI:1154489615
Name:CARITAS GOOD SAMARITAN MEDICAL CENTER
Entity Type:Organization
Organization Name:CARITAS GOOD SAMARITAN MEDICAL CENTER
Other - Org Name:NORCAP LODGE
Other - Org Type:Other Name
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGELIO
Authorized Official - Middle Name:D
Authorized Official - Last Name:BAYOG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-698-1110
Mailing Address - Street 1:71 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:71 WALNUT ST
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2533
Practice Address - Country:US
Practice Address - Phone:508-698-1110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA40818276400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit