Provider Demographics
NPI:1174142509
Name:GOLDEN YEARS BEHAVIORAL HEALTH GROUP INC.
Entity type:Organization
Organization Name:GOLDEN YEARS BEHAVIORAL HEALTH GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MINEO
Authorized Official - Suffix:
Authorized Official - Credentials:LADCI
Authorized Official - Phone:413-224-2015
Mailing Address - Street 1:18 SHAKER ROAD
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028
Mailing Address - Country:US
Mailing Address - Phone:413-224-2015
Mailing Address - Fax:413-183-4994
Practice Address - Street 1:16 SHAKER ROAD
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028
Practice Address - Country:US
Practice Address - Phone:413-209-8208
Practice Address - Fax:413-287-9737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-15
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty