DEVENS TREATMENT & RECOVERY CENTER, LLC (NPI# 1063876241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063876241 |
| Entity Type | Organization |
| Organization Name | DEVENS TREATMENT & RECOVERY CENTER, LLC |
| Other Organization Name | TARAVISTA BEHAVIORAL HEALTH CENTER |
| Practice Address |
85 Patton Rd Devens MA 01434-4401 |
| Practice Telephone | 9786155200 |
| Mailing Telephone | 9786155200 |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2016-04-13 |
| Authorized Official Name | MICHAEL PHILIP KRUPA (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 7819790700 |
| Authorized Official Credential | ED.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | Hospitals |
| Other Name | Type Code |
|---|---|
| TaraVista Behavioral Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811473267 | Devens Treatment & Recovery Center, LLC | Nurse Practitioner | 85 Patton Rd, Devens, MA 01434-4401 | 2018-07-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | DEVENS TREATMENT & RECOVERY CENTER, LLC | 48 Mt. Vernon Street, Winchester, MA 01890 |
| Street Address |
85 PATTON RD |
| City | DEVENS |
| State | MA |
| Zip Code | 01434-4401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962451716 | Craig M Coldwell | Psychiatry & Neurology | 85 Patton Rd, Devens, MA 01434-4401 | 2006-05-09 |
| 1649888702 | Yangchen Tenzin Gethoktsang | Nurse Practitioner | 85 Patton Rd, Devens, MA 01434-4401 | 2020-07-15 |
| 1689208050 | Jean-merimee Kouagheu | Registered Nurse | 85 Patton Rd, Devens, MA 01434-4401 | 2020-02-25 |
| 1518514884 | Kerrie Moran | Nurse Practitioner | 85 Patton Rd, Devens, MA 01434 | 2019-08-21 |
| 1710547385 | Amanda Irene Gustafson | Physician Assistant | 85 Patton Rd, Devens, MA 01434-4401 | 2019-06-17 |
| 1063984540 | Christine Elizabeth Manseau | Physician Assistant | 85 Patton Rd, Devens, MA 01434-4401 | 2018-12-21 |
| 1184195521 | Kendra Beth Allan | Physician Assistant | 85 Patton Rd, Devens, MA 01434-4401 | 2018-12-11 |
| 1922589134 | Jean Marie Barrile | Social Worker | 85 Patton Rd, Devens, MA 01434-4401 | 2018-08-25 |
| 1811473267 | Devens Treatment & Recovery Center, LLC | Nurse Practitioner | 85 Patton Rd, Devens, MA 01434-4401 | 2018-07-18 |
| 1336693951 | Alison Ballantyne | Nurse Practitioner | 85 Patton Rd, Devens, MA 01434-4401 | 2016-08-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598063794 | Erik Pfundstein | Physical Therapist | 399th Combat Support Hospital, Apo, AA 01434 | 2011-03-11 |
| 1245729060 | Ericka Rice-aquino | Psychologist | 42 Patton Rd, Devens, MA 01434-3801 | 2018-05-07 |
| 1700829058 | Diane Kilduff | Internal Medicine | 42 Patton Rd, Ayer, MA 01434-3801 | 2006-06-14 |
| 1861056418 | Dean J. Overmiller | Emergency Medical Technician, Basic | 42 Patton Rd, Ayer, MA 01434-3802 | 2019-04-30 |
| 1982185096 | Robyn Coons | Social Worker | 42 Patton Rd, Ayer, MA 01434-3802 | 2018-08-27 |
| 1043703598 | Paul Anderson | Psychologist | 42 Patton Rd, Devens, MA 01434-3802 | 2018-06-10 |
| 1649769613 | Janet Howson | Psychologist | 42 Patton Rd, Ayer, MA 01434-3802 | 2018-05-05 |
| 1407356421 | Christina L Cozza | Social Worker | 42 Patton Rd, Ayer, MA 01434-3802 | 2018-02-16 |
| 1578085114 | Chelsea Coffey | Physician Assistant | 42 Patton Rd, Devens, MA 01434-3802 | 2017-07-15 |
| 1497175970 | Michaela Alexis Montecalvo | Physician Assistant | 42 Patton Rd, Ayer, MA 01434-3802 | 2014-04-23 |
| Find all providers in zip 01434 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861901910 | Westborough Behavioral Healthcare Hospital, LLC | Psychiatric Hospital | 300 Friberg Pkwy, Westborough, MA 01581-3900 | 2017-09-20 |
| 1790223220 | Uhs of Westwood Pembroke | Psychiatric Hospital | 456 Mammoth Rd Apt 2, Dracut, MA 01826-6157 | 2017-02-04 |
| 1639615685 | Mariel Catherine Marfongelli | Psychiatric Hospital | 537 E 6th St Apt 1, Boston, MA 02127-3070 | 2017-01-15 |
| 1801041306 | Anne Mullaney | Psychiatric Hospital | 57 Settler Rd, Plymouth, MA 02360-2959 | 2008-11-25 |
| 1104077544 | Va Medical Center Brockton Ma | Psychiatric Hospital | 25 Belmont Ct Apt 8, Brockton, MA 02301-4730 | 2008-10-03 |
| 1497947899 | Boston Medical Center | Psychiatric Hospital | 272 Albion St, Apt 3, Wakefield, MA 01880-3154 | 2007-08-10 |
| 1346385267 | Claudia Helen Orleans | Psychiatric Hospital | 8 Hillcrest Ave, Nahant, MA 01908-1113 | 2007-02-20 |
| 1881787455 | Department of Mental Health | Psychiatric Hospital | 288 Lyman St., Westboro, MA 01581 | 2006-10-02 |
| 1407884059 | The Commonwealth of Massachusetts | Psychiatric Hospital | 460 Quincy Ave, Quincy, MA 02169-8130 | 2006-06-30 |
| 1619944105 | Cambridge Health Alliance | Psychiatric Hospital | 156 Raymond St, Apt 2, Cambridge, MA 02140-3315 | 2006-03-02 |
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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.