Provider Demographics
NPI:1497823579
Name:CARITAS CARNEY HOSPITAL-PSYCHIATRY
Entity Type:Organization
Organization Name:CARITAS CARNEY HOSPITAL-PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GUYON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-789-3450
Mailing Address - Street 1:795 MIDDLE ST
Mailing Address - Street 2:SAINT ANNE'S HOSPITAL
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-1733
Mailing Address - Country:US
Mailing Address - Phone:508-235-5401
Mailing Address - Fax:508-235-5330
Practice Address - Street 1:2100 DORCHESTER AVENUE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02124
Practice Address - Country:US
Practice Address - Phone:617-296-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1010352Medicaid
MA22-S017Medicare PIN