Provider Demographics
NPI:1720765175
Name:D&T BEHAVIORAL HEALTH, LLC.
Entity Type:Organization
Organization Name:D&T BEHAVIORAL HEALTH, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:MENARD
Authorized Official - Suffix:
Authorized Official - Credentials:LDAC I
Authorized Official - Phone:508-558-6955
Mailing Address - Street 1:5 HIGHLAND CT
Mailing Address - Street 2:
Mailing Address - City:WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02571-1471
Mailing Address - Country:US
Mailing Address - Phone:508-558-6955
Mailing Address - Fax:
Practice Address - Street 1:25 OLD WESTPORT RD
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-2537
Practice Address - Country:US
Practice Address - Phone:508-802-5289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health