CUSHING MANOR (NPI# 1487796488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487796488 |
| Entity Type | Organization |
| Organization Name | CUSHING MANOR |
| Practice Address |
20 Cushing Ave Dorchester MA 02125-2027 |
| Practice Telephone | 6172880400 |
| Mailing Telephone | 6172880400 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | FRED D WRIGHT (PRESIDENT) |
| Authorized Official Telephone | 6172880400 |
| Authorized Official Credential | MPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | ========= | MA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 5507995 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | CUSHING MANOR INN LLC | 508 W. Washington Street, South Bend, IN 46601 |
| Street Address |
20 CUSHING AVE |
| City | DORCHESTER |
| State | MA |
| Zip Code | 02125-2027 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922520840 | Aj Guerrero | Counselor | 6 Glen St. #3, Boston, MA 02125 | 2017-07-12 |
| 1982059218 | Ana Fernandez | Psychologist | University of Massachusetts, Boston, 100 William T. Morrissey Blvd, Boston, MA 02125 | 2016-04-23 |
| 1558725184 | Algecira Garcia-ortiz | Massage Therapist | 12 Judson St, Dorchester, MASSACHUSETTS 02125 | 2016-04-10 |
| 1508251414 | Sing Hong Ty | Registered Nurse | 415 Colombia Rd, Dorchester, MA 02125 | 2015-03-30 |
| 1972806750 | Joanne Pomales | Counselor | 18 Harbor Crest Court 102, Dorchester, MA 02125 | 2010-12-16 |
| 1386969335 | Kara Jillian Sheridan | Counselor | 58 Dorset St, Boston, MA 02125 | 2010-04-02 |
| 1750533956 | Wendy M. Jern | Physical Therapist | 21riley Rd #2, Hyde Park, MA 02125 | 2008-10-21 |
| 1174729743 | Payton Brandyberry | Counselor | 500 Columbia Rd, Mail Stop 415-05, Upham's Corner Health Center, Dorchester, MA 02125 | 2007-06-21 |
| 1699817247 | Dong Lan Corporation | Pharmacist | 1167 A Dorchester Ave, Dorchester, MA 02125 | 2007-02-12 |
| 1457490153 | Sarah L Merin | Social Worker | Upham's Corner Health Center, 500 Columbia Rd, Mailstop 415-05, Dorchester, MA 02125 | 2007-02-06 |
| Find all providers in zip 02125 | ||||
| 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 |
|---|---|---|---|---|
| 1487101952 | Home for Little Wanderers Sah Boston | Community Based Residential Treatment Facility, Mental Illness | 50 Redfield St, Unit 300, Dorchester, MA 02122 | 2016-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144769167 | Aloria Health of Worcester, LLC | Community Based Residential Treatment Facility, Mental Illness | 1183 Main St, Worcester, MA 01603 | 2017-02-23 |
| 1952784506 | Justice Resource Institute | Community Based Residential Treatment Facility, Mental Illness | 262 Crescent St, Waltham, MA 02453-3417 | 2015-07-01 |
| 1639564214 | Northeast Behavioral Associates | Community Based Residential Treatment Facility, Mental Illness | 23 Dailey Rd, Brockton, MA 02302-2250 | 2015-04-01 |
| 1346641313 | Penikese Island School, Inc | Community Based Residential Treatment Facility, Mental Illness | 565 Woods Hole Rd, Woods Hole, MA 02543-1041 | 2014-09-10 |
| 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 |
| 1851627988 | Hampden County Sherriff's Department | Community Based Residential Treatment Facility, Mental Illness | 701 Center St, Chicopee, MA 01013-1588 | 2009-10-24 |
| 1184958423 | Joseph D Reich | Community Based Residential Treatment Facility, Mental Illness | 475 State Rd, Plymouth, MA 02360-5185 | 2009-09-18 |
| 1922127349 | Department of Mental Health | Community Based Residential Treatment Facility, Mental Illness | Westborough State Hospital Chauncy Hall, Lyman St Daniels 1, Westborough, MA 01581 | 2007-03-28 |
| 1568580736 | Department of Mental Health | Community Based Residential Treatment Facility, Mental Illness | Brighton Irtp - Everett House, 232 Centre St, Dorchester Center, MA 02124-2334 | 2007-03-27 |
| Find all providers with the same taxonomy | ||||
| City | DORCHESTER |
| Zip Code | 02125 |
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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.