Provider Demographics
NPI:1346397437
Name:BEHAVIORAL HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMJAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHNASSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-753-5554
Mailing Address - Street 1:435 SHREWSBURY ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-1689
Mailing Address - Country:US
Mailing Address - Phone:508-753-5554
Mailing Address - Fax:508-752-7245
Practice Address - Street 1:435 SHREWSBURY ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-1689
Practice Address - Country:US
Practice Address - Phone:508-753-5554
Practice Address - Fax:508-752-0245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA595552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3032389Medicaid
MA3032389Medicaid
MAJ07208Medicare ID - Type Unspecified