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735 Morrissey Blvd Boston MA 02122-3406 | |
| (617) 365-0637 | |
| (617) 282-9659 |
| Full Name | |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 735 Morrissey Blvd, Boston, Massachusetts |
| Authorized Official Name and Position | Ulric R Johnson (OWNER) |
| Authorized Official Contact | 61733650637 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2 Moody St Boston MA 02124-3507 Ph: (617) 365-0637 | 735 Morrissey Blvd Boston MA 02122-3406 Ph: (617) 365-0637 |
| NPI Number | 1649516220 |
|---|---|
| Provider Enumeration Date | 12/30/2012 |
| Last Update Date | 02/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649516220 | NPI | - | NPPES |
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