Provider Demographics
NPI:1942351010
Name:BROCKTON NEIGHBORHOOD HEALTH CENTER
Entity Type:Organization
Organization Name:BROCKTON NEIGHBORHOOD HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:SARABIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-559-6699
Mailing Address - Street 1:157 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4012
Mailing Address - Country:US
Mailing Address - Phone:508-559-6699
Mailing Address - Fax:508-583-4649
Practice Address - Street 1:231 MAIN ST 3RD
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301
Practice Address - Country:US
Practice Address - Phone:508-559-1567
Practice Address - Fax:508-559-5073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213531213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty