Provider Demographics
NPI:1467507293
Name:BEHAVIORAL HEALTH NETWORK, INC
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH NETWORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FOLLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-301-9403
Mailing Address - Street 1:PO BOX 2738
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01101-2738
Mailing Address - Country:US
Mailing Address - Phone:413-747-0705
Mailing Address - Fax:413-732-7075
Practice Address - Street 1:417 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3736
Practice Address - Country:US
Practice Address - Phone:413-301-9403
Practice Address - Fax:413-732-7075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1800779OtherMASS HEALTH
MA831734OtherTUFTS
MAEI0029OtherBLUE CROSS BLUE SHIELD MA