| Dld-parella | |
|
19 Vinson St Worcester MA 01605-3990 | |
| (774) 441-4501 | |
| Not Available |
| Full Name | Dld-parella |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 19 Vinson St, Worcester, Massachusetts |
| Authorized Official Name and Position | Luis A Diaz (CEO) |
| Authorized Official Contact | 7744414501 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dld-parella 19 Vinson St Apt 3 Worcester MA 01605-3990 Ph: (774) 441-4501 | Dld-parella 19 Vinson St Worcester MA 01605-3990 Ph: (774) 441-4501 |
| NPI Number | 1457116279 |
|---|---|
| Provider Enumeration Date | 02/20/2024 |
| Last Update Date | 02/20/2024 |
| Certification Date | 02/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457116279 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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