Organization
GAVIN FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MCGAHAN LADC I (PRESIDENT/CEO)
(617) 268-5517
Entity
Organization
Contact information
Practice address
49 L ST, SOUTH BOSTON, MA 02127-1511
(617) 268-5000
(617) 268-5008
Mailing address
675 E 4TH ST, SOUTH BOSTON, MA 02127-3063
(617) 268-5517
(617) 269-3296
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
0853
MA
Other
Enumeration date
09/22/2009
Last updated
09/22/2009
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