| Massachusetts General Hospital Revere Healthcare Center | |
| 
					300 Ocean Ave Revere MA 02151-3675  | |
| (617) 510-9458 | |
| (781) 485-6119 | 
| Full Name | Massachusetts General Hospital Revere Healthcare Center | 
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) | 
| Location | 300 Ocean Ave, Revere, Massachusetts | 
| Authorized Official Name and Position | Marykate P Shorter (SOCIAL WORKER) | 
| Authorized Official Contact | 7814856112 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Massachusetts General Hospital Revere Healthcare Center 416 Marlborough St #708 Boston MA 02115-1544 Ph: (617) 510-9458  | Massachusetts General Hospital Revere Healthcare Center 300 Ocean Ave Revere MA 02151-3675 Ph: (617) 510-9458  | 
| NPI Number | 1871715151 | 
|---|---|
| Provider Enumeration Date | 05/03/2007 | 
| Last Update Date | 08/22/2020 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1871715151 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 111447 (Massachusetts) | Primary | 
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