Provider Demographics
NPI:1164806295
Name:BAY COVE HUMAN RESOURCES
Entity Type:Organization
Organization Name:BAY COVE HUMAN RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:SPRAGU
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:617-371-3003
Mailing Address - Street 1:863 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02124-5205
Mailing Address - Country:US
Mailing Address - Phone:978-930-5508
Mailing Address - Fax:
Practice Address - Street 1:863 ADAMS ST
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02124
Practice Address - Country:US
Practice Address - Phone:978-930-5508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-18
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
MAS73597186251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health