Organization
BOSTON ALCOHOL AND SUBSTANCE ABUSE PROGRAM
Active
Organization
BOSTON ALCOHOL AND SUBSTANCE ABUSE PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS J DELANEY MSW (EXECUTIVE DIRECTOR)
(617) 482-5292
Entity
Organization
Contact information
Practice address
30 WINTER ST, 3RD FLOOR, BOSTON, MA 02108-4720
(617) 482-5292
(617) 482-5232
Mailing address
30 WINTER ST, 3RD FLOOR, BOSTON, MA 02108-4720
(617) 482-5292
(617) 482-5232
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
0585
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013160
NEIGHBORHOOD HEALTH PLAN
MA
01
—
1312626
MASSHEALTH
MA
01
—
2223020540
BLUE CROSS BLUE SHIELD
MA
Enumeration date
11/02/2006
Last updated
08/22/2020
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