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Organization
MASSACHUSETTS CENTER FOR ADOLESCENT WELLNESS, LLC
Active
Organization
MASSACHUSETTS CENTER FOR ADOLESCENT WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ED THATCHER (CHIEF FINANCIAL OFFICER)
(754) 217-8127
Entity
Organization
Contact information
Practice address
230 BROADWAY STE 201, LYNNFIELD, MA 01940-2320
(781) 334-8781
Mailing address
230 BROADWAY STE 201, LYNNFIELD, MA 01940-2320
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
NULL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NULL
Other
Enumeration date
02/09/2023
Last updated
05/28/2024
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