| Fbtc Transitional Sub, Llc | |
|
55 Tozer Rd Beverly MA 01915-5515 | |
| (978) 969-2894 | |
| Not Available |
| Full Name | Fbtc Transitional Sub, Llc |
|---|---|
| Speciality | Clinic/center - Hearing And Speech |
| Location | 55 Tozer Rd, Beverly, Massachusetts |
| Authorized Official Name and Position | Mary Patricia Rodenberg-roberts (VP& SR ASST GENERAL COUNSEL) |
| Authorized Official Contact | 9528362234 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fbtc Transitional Sub, Llc 55 Tozer Rd Beverly MA 01915-5515 Ph: () - | Fbtc Transitional Sub, Llc 55 Tozer Rd Beverly MA 01915-5515 Ph: (978) 969-2894 |
| NPI Number | 1619553187 |
|---|---|
| Provider Enumeration Date | 03/23/2021 |
| Last Update Date | 11/27/2023 |
| Certification Date | 11/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619553187 | NPI | - | NPPES |
| 110078808A | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QH0700X | Clinic/center - Hearing And Speech | (* (Not Available)) | Primary |
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