Provider Demographics
NPI:1497339634
Name:UBHS - UNLIMITED BEHAVIORAL HEALTH SERVICES INC
Entity Type:Organization
Organization Name:UBHS - UNLIMITED BEHAVIORAL HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWINNA
Authorized Official - Middle Name:
Authorized Official - Last Name:WYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-763-7272
Mailing Address - Street 1:225 QUINCY AVE
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-2864
Mailing Address - Country:US
Mailing Address - Phone:888-763-7272
Mailing Address - Fax:877-243-2959
Practice Address - Street 1:225 QUINCY AVE
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-2864
Practice Address - Country:US
Practice Address - Phone:888-763-7272
Practice Address - Fax:877-243-2959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty