Provider Demographics
NPI:1336362870
Name:CARITAS GOOD SAMARITAN MEDICAL CENTER
Entity Type:Organization
Organization Name:CARITAS GOOD SAMARITAN MEDICAL CENTER
Other - Org Name:NORCAP LODGE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF OUTPATIENT SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:MITCHELL-NIXON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LSWA, LADC I
Authorized Official - Phone:508-698-1117
Mailing Address - Street 1:71 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-2533
Mailing Address - Country:US
Mailing Address - Phone:508-698-1117
Mailing Address - Fax:508-698-3852
Practice Address - Street 1:71 WALNUT ST
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2533
Practice Address - Country:US
Practice Address - Phone:508-698-1117
Practice Address - Fax:508-698-3852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA176086282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital