Organization
JUSTICE RESOURCE INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH JARRELL WALLER (THERAPEUTIC MENTOR)
(617) 987-5977
Entity
Organization
Contact information
Practice address
3 PICKERING AVENUE # 1, BOSTON, MA 02119-2225
(617) 987-5977
Mailing address
3 PICKERING AVE # 1, BOSTON, MA 02119-2225
(617) 987-5977
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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