Provider Demographics
NPI:1306202189
Name:METRO WEST CENTER FOR WELL BEING, LLC
Entity type:Organization
Organization Name:METRO WEST CENTER FOR WELL BEING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLALEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-248-3390
Mailing Address - Street 1:195 MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-1955
Mailing Address - Country:US
Mailing Address - Phone:508-376-6018
Mailing Address - Fax:
Practice Address - Street 1:195 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-1955
Practice Address - Country:US
Practice Address - Phone:508-376-6018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-08
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health