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Organization

CUSHING MANOR

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FRED D WRIGHT MPH (PRESIDENT)
(617) 288-0400
Entity
Organization

Contact information

Practice address
20 CUSHING AVE, DORCHESTER, MA 02125-2027
(617) 288-0400
Mailing address
20 CUSHING AVE, DORCHESTER, MA 02125-2027
(617) 288-0400

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5507995
MA
Enumeration date
02/13/2007
Last updated
07/21/2022
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