Provider Demographics
NPI:1841393998
Name:BALDPATE, INC.
Entity Type:Organization
Organization Name:BALDPATE, INC.
Other - Org Name:BALDPATE HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUCILLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BATAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-352-2131
Mailing Address - Street 1:PO BOX 239
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01833
Mailing Address - Country:US
Mailing Address - Phone:978-352-2131
Mailing Address - Fax:978-352-6755
Practice Address - Street 1:83 BALDPATE RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:MA
Practice Address - Zip Code:01833-2303
Practice Address - Country:US
Practice Address - Phone:978-352-2131
Practice Address - Fax:978-352-6755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA682283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1103032Medicaid
MABAL2222418501OtherMASS BLUE CROSS
MA1899856OtherMBHP
224033Medicare ID - Type Unspecified