Provider Demographics
NPI:1649317595
Name:BAY COVE HUMAN SERVICES, INC
Entity type:Organization
Organization Name:BAY COVE HUMAN SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO & SVP
Authorized Official - Prefix:
Authorized Official - First Name:MARCEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VERNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-619-6961
Mailing Address - Street 1:105 VICTORY RD
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122-3518
Mailing Address - Country:US
Mailing Address - Phone:617-371-3010
Mailing Address - Fax:617-371-3044
Practice Address - Street 1:105 VICTORY RD
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02122-3518
Practice Address - Country:US
Practice Address - Phone:617-371-3010
Practice Address - Fax:617-371-3044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA00000000416OtherBMC HEALTHNET
MA042418575OtherGUARDIAN
MA2060689OtherETNA US HEALTH CARE
MA796212OtherNETWORK HEALTH
MA0035OtherBCBS
MA718549OtherTUFFS
MA0008279OtherNHP
MA1800361Medicaid
MA616020OtherHARVARD PILGRAM
MA1800361Medicaid
MA2060689OtherETNA US HEALTH CARE