Provider Demographics
NPI:1669809125
Name:MONTAGUE BOARD OF HEALTH
Entity type:Organization
Organization Name:MONTAGUE BOARD OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTO
Authorized Official - Prefix:MS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCNEELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-863-3200
Mailing Address - Street 1:1 AVENUE A
Mailing Address - Street 2:
Mailing Address - City:TURNERS FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:01376-1168
Mailing Address - Country:US
Mailing Address - Phone:413-863-3200
Mailing Address - Fax:413-863-3225
Practice Address - Street 1:1 AVENUE A
Practice Address - Street 2:
Practice Address - City:TURNERS FALLS
Practice Address - State:MA
Practice Address - Zip Code:01376-1168
Practice Address - Country:US
Practice Address - Phone:413-863-3200
Practice Address - Fax:413-863-3225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN217540251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare