| 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 |
| 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 |
| Provider Name | Amina Fout |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962035840 PECOS PAC ID: 2264979954 Enrollment ID: I20240730003563 |
| Provider Name | Orobosa Chiedu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659960201 PECOS PAC ID: 4284166208 Enrollment ID: I20241016000544 |
| Provider Name | Vivian O Emuobe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396588471 PECOS PAC ID: 4688109218 Enrollment ID: I20241120000165 |
| Provider Name | Queendroline Nkeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730514381 PECOS PAC ID: 3779922265 Enrollment ID: I20241120003356 |
| Provider Name | Adedayo Elizabeth Dansu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902626716 PECOS PAC ID: 4789112814 Enrollment ID: I20250116002216 |
| Provider Name | Venida Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194598953 PECOS PAC ID: 8820527740 Enrollment ID: I20250122002089 |
| Provider Name | Judith Pierre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427864750 PECOS PAC ID: 0244769610 Enrollment ID: I20250130000459 |
| Provider Name | Airen B Briceno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154056976 PECOS PAC ID: 7315467198 Enrollment ID: I20250224002264 |
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