Organization
ABAC
Active
Parent organization
PROGRAM SERVICES
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROGRAM SERVICES
Authorized official
MATEUS BARBOSA (CLINICIAN)
(617) 650-8146
Entity
Organization
Contact information
Practice address
35 FOX ST, DORCHESTER, MA 02122
(617) 650-8146
Mailing address
35 FOX ST, DORCHESTER, MA 02122-1722
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
10/09/2009
Last updated
10/09/2009
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