Provider Demographics
NPI:1770685232
Name:DELPHI CENTER OF QUINCY, INC.
Entity type:Organization
Organization Name:DELPHI CENTER OF QUINCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-786-0137
Mailing Address - Street 1:234 COPELAND ST
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4005
Mailing Address - Country:US
Mailing Address - Phone:617-786-0137
Mailing Address - Fax:617-479-4798
Practice Address - Street 1:234 COPELAND ST
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4005
Practice Address - Country:US
Practice Address - Phone:617-786-0137
Practice Address - Fax:617-479-4798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-03
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1056111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA724276OtherTUFTS HEALTH CARE
MA001293OtherMEDICARE PTAN
MA001293OtherMEDICARE PTAN