Provider Demographics
NPI:1851624696
Name:BEHAVIORAL ASSOCIATES OF MASSACHUSETTS INC.
Entity Type:Organization
Organization Name:BEHAVIORAL ASSOCIATES OF MASSACHUSETTS INC.
Other - Org Name:HALCYON CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE CONSULTING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRODEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:401-274-6310
Mailing Address - Street 1:86 MOUNT HOPE AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-1648
Mailing Address - Country:US
Mailing Address - Phone:401-274-6310
Mailing Address - Fax:401-421-3280
Practice Address - Street 1:55 PLAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-4107
Practice Address - Country:US
Practice Address - Phone:508-699-2399
Practice Address - Fax:508-699-9475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA726798251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services