Organization
RIVERSIDE COMMUNITY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE MARIE FICKES (INTENSIVE CARE COORDINATOR)
(781) 364-0940
Entity
Organization
Contact information
Practice address
12 TYLER ST, SOMERVILLE, MA 02143-3241
(781) 364-0940
Mailing address
12 TYLER ST, SOMERVILLE, MA 02143-3241
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/09/2015
Last updated
07/09/2015
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