Provider Demographics
NPI:1184963993
Name:BAY COAST BEHAVIORAL, LLC
Entity type:Organization
Organization Name:BAY COAST BEHAVIORAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:MAURIE
Authorized Official - Last Name:PATCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-294-5722
Mailing Address - Street 1:170 PLEASANT ST
Mailing Address - Street 2:ROOM 100
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-3015
Mailing Address - Country:US
Mailing Address - Phone:774-294-5722
Mailing Address - Fax:774-294-5724
Practice Address - Street 1:170 PLEASANT ST
Practice Address - Street 2:ROOM 100
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-3015
Practice Address - Country:US
Practice Address - Phone:774-294-5722
Practice Address - Fax:774-294-5724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-14
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty