Provider Demographics
NPI:1477296036
Name:ADVANCE BEHAVIOR HEALTHCARE ASSOCIATE INC
Entity Type:Organization
Organization Name:ADVANCE BEHAVIOR HEALTHCARE ASSOCIATE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:508-743-5542
Mailing Address - Street 1:61 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02762-1966
Mailing Address - Country:US
Mailing Address - Phone:508-743-5542
Mailing Address - Fax:
Practice Address - Street 1:243 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUZZARDS BAY
Practice Address - State:MA
Practice Address - Zip Code:02532-3229
Practice Address - Country:US
Practice Address - Phone:508-743-5542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Single Specialty