Provider Demographics
NPI:1528071230
Name:SEVEN HILLS BEHAVIORAL HEALTH, INC.
Entity type:Organization
Organization Name:SEVEN HILLS BEHAVIORAL HEALTH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-634-3917
Mailing Address - Street 1:589 SOUTH FIRST STREET
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740
Mailing Address - Country:US
Mailing Address - Phone:508-996-3147
Mailing Address - Fax:508-991-4999
Practice Address - Street 1:589 S 1ST ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-5716
Practice Address - Country:US
Practice Address - Phone:508-996-3147
Practice Address - Fax:508-991-4999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4931 MENTAL HEALTH261Q00000X
MA0591 SUBSTANCE ABUSE261Q00000X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1002190OtherBEACON HEALTH
MA1301055Medicaid
MA1310674Medicaid
MAM18702OtherBLUE CROSS/BLUE SHIELD
MA30560/5359999OtherMA DEPT OF PUBLIC HEALTH
MA00000020645OtherBOSTON MEDICAL CENTER
MA1305484Medicaid
MA1305492Medicaid
MA1308467Medicaid
MA30560/4359999OtherMA DEPT OF PUBLIC HEALTH
MA31560/4358103OtherMA DEPT OF PUBLIC HEALTH
RI94344OtherRI BLUE CROSS
S017270OtherTRICARE
MA33560/4362026OtherMA DEPT OF PUBLIC HEALTH
MA52560/5358103OtherMA DEPT OF PUBLIC HEALTH
MA1306367Medicaid
MA1310402Medicaid
MA722496OtherTUFTS
A007840OtherVALUE OPTIONS(PACIFICARE)
MA1301055Medicaid