Provider Demographics
NPI:1740336858
Name:SOUTH MIDDLESEX OPPORTUNITY COUNCIL INC
Entity type:Organization
Organization Name:SOUTH MIDDLESEX OPPORTUNITY COUNCIL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CUDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-620-2300
Mailing Address - Street 1:7 BISHOP ST
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-8323
Mailing Address - Country:US
Mailing Address - Phone:508-879-2250
Mailing Address - Fax:508-620-2637
Practice Address - Street 1:300 HOWARD ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-8313
Practice Address - Country:US
Practice Address - Phone:508-879-2250
Practice Address - Fax:508-620-2637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4054251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA187864000OtherMAGELLAN BEHAVIORAL HEALT
MA110027995CMedicaid
MA20409OtherBMC HEALTHNET
MA981409OtherNETWORK HEALTH
MA1300431OtherMASS BEHAVIORAL HEALTH PA
MA1010730OtherBEACON HEALTH STRATEGIES
MA606962OtherTUFTS HEALTH PLAN
MAM18714OtherBLUE CROSS BLUE SHIELD
MA5238537OtherAETNA
MA110027995CMedicaid