| Engrace Behavioral Health Services Llc | |
|
950 N Main St # 202 Randolph MA 02368-3064 | |
| (617) 203-2009 | |
| Not Available |
| Full Name | Engrace Behavioral Health Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 950 N Main St # 202, Randolph, Massachusetts |
| Authorized Official Name and Position | Juliana Igbinosun (NP) |
| Authorized Official Contact | 6172032009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Engrace Behavioral Health Services Llc 950 N Main St # 202 Randolph MA 02368-3064 Ph: (617) 203-2009 | Engrace Behavioral Health Services Llc 950 N Main St # 202 Randolph MA 02368-3064 Ph: (617) 203-2009 |
| NPI Number | 1013416387 |
|---|---|
| Provider Enumeration Date | 02/01/2018 |
| Last Update Date | 03/12/2024 |
| Certification Date | 03/12/2024 |
| Medicare PECOS PAC ID | 7214292069 |
|---|---|
| Medicare Enrollment ID | O20180525000621 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013416387 | NPI | - | NPPES |
| Provider Name | Juliana Igbinosun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417468463 PECOS PAC ID: 8123383973 Enrollment ID: I20180525000780 |
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