Basic Information
| Provider Information | |||||||||
| NPI: | 1740336858 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUTH MIDDLESEX OPPORTUNITY COUNCIL INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 BISHOP ST | ||||||||
| Address2: | |||||||||
| City: | FRAMINGHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017028323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088792250 | ||||||||
| FaxNumber: | 5086202637 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 HOWARD ST | ||||||||
| Address2: | |||||||||
| City: | FRAMINGHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017028313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088792250 | ||||||||
| FaxNumber: | 5086202637 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2007 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| AuthorizedOfficialLastName: | CUDDY | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5086202300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 4054 | MA | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 187864000 | 01 | MA | MAGELLAN BEHAVIORAL HEALT | OTHER | 110027995C | 05 | MA | MEDICAID | 20409 | 01 | MA | BMC HEALTHNET | OTHER | 981409 | 01 | MA | NETWORK HEALTH | OTHER | 1300431 | 01 | MA | MASS BEHAVIORAL HEALTH PA | OTHER | 1010730 | 01 | MA | BEACON HEALTH STRATEGIES | OTHER | 606962 | 01 | MA | TUFTS HEALTH PLAN | OTHER | M18714 | 01 | MA | BLUE CROSS BLUE SHIELD | OTHER | 5238537 | 01 | MA | AETNA | OTHER |