Organization
SOUTH MIDDLESEX OPPORTUNITY COUNCIL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK KINCHLA PSYD (DIRECTOR OF SUBSTANCE ABUSE)
(508) 879-2250
Entity
Organization
Contact information
Practice address
300 HOWARD ST, FRAMINGHAM, MA 01702-8313
(508) 879-2250
(508) 879-2581
Mailing address
300 HOWARD ST, FRAMINGHAM, MA 01702-8313
(508) 879-2250
(508) 879-2581
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110027995C
—
MA
Enumeration date
08/24/2011
Last updated
08/24/2011
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