MINDCARE AGENCY PC; NPI #1730557018

Contact Information

MINDCARE AGENCY PC

125 LIBERTY ST
SUITE 205
SPRINGFIELD, MA 01103-1114

Phone: 413-271-7136
Fax: 413-271-7137
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Addiction Medicine	2084A0401X	79	Physician/Addiction Medicine
Community/Behavioral Health	251S00000X
Rehabilitation, Substance Use Disorder	261QR0405X

Indicates primary specialty

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NPI Profile & details for MINDCARE AGENCY PC

NPI Number 1730557018

LBN Legal business name MINDCARE AGENCY PC

Authorized official OMAR FARUK - (CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 09/03/2015

Last updated 11/18/2019 - About 7 years ago

Identifiers

MA	License #	223674
MA	Other	223674	STATE LICENSE NUMBER

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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