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Organization
REVIDAS LLC
Active
Organization
REVIDAS LLC
Active
Other names
Revidas
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEOFFREY CUSHNER (MANAGING DIRECTOR)
(508) 304-7499
Entity
Organization
Contact information
Practice address
108 GROVE STREET, SUITE LL11, WORCESTER, MA 01605-2677
(508) 304-7499
(774) 420-7255
Mailing address
108 GROVE STREET, SUITE LL11, WORCESTER, MA 01605-2677
(508) 304-7499
(774) 420-7255
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3875
MA
Other
Enumeration date
07/12/2016
Last updated
10/01/2024
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