Provider Demographics
NPI:1598400442
Name:NR MASSACHUSETTS ASSOCIATES LLC
Entity Type:Organization
Organization Name:NR MASSACHUSETTS ASSOCIATES LLC
Other - Org Name:RETREAT BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SANTOS-PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-473-9426
Mailing Address - Street 1:1170 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-2601
Mailing Address - Country:US
Mailing Address - Phone:178-598-8107
Mailing Address - Fax:800-915-6119
Practice Address - Street 1:1330 BEACON ST STE 355
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-3202
Practice Address - Country:US
Practice Address - Phone:717-859-8810
Practice Address - Fax:800-915-6119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-04
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health