Organization
PINESTREET INN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYNDIA DOWNEY (EXECUTIVE DIRECTOR)
(617) 892-9105
Entity
Organization
Contact information
Practice address
170 MORTON ST, JAMAICA PLAIN, MA 02130-3735
(617) 892-9451
(617) 521-7261
Mailing address
444 HARRISON AVE, BOSTON, MA 02118-2404
(617) 892-9451
(617) 521-7261
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
MA
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
0817
MA
Other
Enumeration date
04/13/2012
Last updated
05/17/2012
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