Provider Demographics
NPI:1215227921
Name:LAMOUR COMMUNITY HEALTH INSTITUTE, INC
Entity Type:Organization
Organization Name:LAMOUR COMMUNITY HEALTH INSTITUTE, INC
Other - Org Name:LAMOUR COMMUNITY HEALTH INSTITUTE, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:781-885-7252
Mailing Address - Street 1:42 DIAUTO DRIVE
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4510
Mailing Address - Country:US
Mailing Address - Phone:781-885-7252
Mailing Address - Fax:
Practice Address - Street 1:500 N MAIN ST
Practice Address - Street 2:SUITE D.
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-6700
Practice Address - Country:US
Practice Address - Phone:781-885-7252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-14
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty