Provider Demographics
NPI:1003913096
Name:BRIGHAM & WOMEN'S HOSPITAL
Entity type:Organization
Organization Name:BRIGHAM & WOMEN'S HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MENTAL HEALTH DEPARTMEN
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:617-983-4225
Mailing Address - Street 1:640 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2555
Mailing Address - Country:US
Mailing Address - Phone:617-983-4235
Mailing Address - Fax:
Practice Address - Street 1:640 CENTRE ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2555
Practice Address - Country:US
Practice Address - Phone:617-983-4235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA212429283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital