Organization
COASTAL ABA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM CLARK BCBA (MANAGER)
(617) 620-8588
Entity
Organization
Contact information
Practice address
120 LAUREL ST, DUXBURY, MA 02332-2936
(617) 620-8588
Mailing address
120 LAUREL ST, DUXBURY, MA 02332-2936
(617) 620-8588
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1107529
MA
Other
Enumeration date
09/16/2015
Last updated
09/16/2015
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