Organization
BEAVERBROOK STEP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VIRGINIA A CONNOLLY M.ED, LMHC, LCSW (EXECUTIVE DIRECTOR)
(617) 926-1113
Entity
Organization
Contact information
Practice address
85 MAIN ST, 2ND FLOOR, WATERTOWN, MA 02472-4411
(617) 974-0148
(617) 926-1227
Mailing address
85 MAIN ST, 2ND FLOOR, WATERTOWN, MA 02472-4411
(617) 974-0148
(617) 926-1227
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
201069
MA
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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