LAUREL HILL INN, LTD (NPI# 1134270341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134270341 |
| Entity Type | Organization |
| Organization Name | LAUREL HILL INN, LTD |
| Practice Address |
121 Mystic St Medford MA 02155-3463 |
| Mailing Address |
6100 Sw 76th St South Miami FL 33143-5002 |
| Practice Telephone | 7813918000 |
| Practice Fax Number | 7813918008 |
| Mailing Telephone | 3056631876 |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2020-03-04 |
| Authorized Official Name | MIKE BAGLEY (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3056631876 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Laurel Hill Inn | Other Name - Individual/Organization |
| Street Address |
121 MYSTIC ST |
| City | MEDFORD |
| State | MA |
| Zip Code | 02155-3463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255874582 | Elise Morrell | Nurse Practitioner | 121 Mystic St, Medford, MA 02155 | 2016-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679113922 | Elena Chapman | Nurse Practitioner | 293 Salem St 4, Medford, MA 02155 | 2020-01-14 |
| 1922658830 | Michelle Anne Zona | Counselor | 100 George Hassett Dr, Medford, MA 02155 | 2019-09-13 |
| 1487138509 | Dava Davainis | Social Worker | 76 Newbern Avenue, Apt. 1, Medford, MA 02155 | 2018-09-25 |
| 1265915128 | Erin Roberts | Counselor | Medford Public Schools, 3002 Mystic Valley Pkwy, Medford, MA 02155 | 2018-09-07 |
| 1871075739 | Janice Madeline Cole | Social Worker | 3820 Mystic Valley Pkwy Unit 805, Medford, MA 02155 | 2018-09-06 |
| 1447732573 | Mystick Women's Health, Inc. | Obstetrics & Gynecology | 13 Bradlee Road, Medford, MA 02155 | 2018-09-05 |
| 1144713090 | Laura Rogers | Psychologist | 203 Paige Hall, 12 Upper Campus Road, Medford, MA 02155 | 2018-06-14 |
| 1871086694 | Shuo Yang | Dentist | 8 9th St Apt 310, Medford, MA 02155 | 2018-06-07 |
| 1891287108 | Xuhua Qin | Psychologist | 120 Curtis Street, Medford, MA 02155 | 2018-06-01 |
| 1568953529 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 471 Salem St, Medford, MA 02155 | 2018-05-25 |
| Find all providers in zip 02155 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508218553 | Columbiacare Serices | Community Based Residential Treatment Facility, Mental Illness | 1998 Sky Park Dr Ste 102, Medford, OR 97504-5395 | 2016-07-01 |
| 1003262106 | Catholic Charities Diocese of Trenton | Community Based Residential Treatment Facility, Mental Illness | 417 Tabernacle Rd, Medford, NJ 08055-2019 | 2016-05-06 |
| 1750780227 | Westbridge Inc | Community Based Residential Treatment Facility, Mental Illness | 275 Mystic Ave, Ste C, Medford, MA 02155-6301 | 2014-08-20 |
| 1780966606 | Walgreens | Community Based Residential Treatment Facility, Mental Illness | 113 Monument St, Medford, MA 02155-3538 | 2011-09-16 |
| 1861918278 | Columbiacare Services Inc | Community Based Residential Treatment Facility, Mental Illness | 2016 Terrel Dr, Medford, OR 97501-8154 | 2017-08-17 |
| 1548511694 | Options for Southern Oregon | Community Based Residential Treatment Facility, Mental Illness | 1911 Hazel Ave, Medford, OR 97501-1630 | 2012-09-28 |
| 1508126368 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3587 Heathrow Way, Medford, OR 97504-4004 | 2012-05-25 |
| 1104186014 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3587 Heathrow Way, Medford, OR 97504-4004 | 2012-05-24 |
| 1780988253 | Jackson County Mental Health | Community Based Residential Treatment Facility, Mental Illness | 1911 Hazel Ave, Medford, OR 97501-1630 | 2010-12-27 |
| 1649466475 | Columbiacare Services Inc | Community Based Residential Treatment Facility, Mental Illness | 3587 Heathrow Way, Medford, OR 97504 | 2007-09-14 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.