Organization
SPRRRRR LC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CICELY PAYNE (DIRECTOR)
(857) 261-2011
Entity
Organization
Contact information
Practice address
91 COLORADO ST, MATTAPAN, MA 02126-1347
(857) 261-2011
(617) 698-0871
Mailing address
91 COLORADO ST, MATTAPAN, MA 02126-1347
(857) 261-2011
(617) 698-0871
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346662319
NPI
—
Enumeration date
12/08/2018
Last updated
12/08/2018
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