Organization
MORGANMEMORIAL GOODWILL IND.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MICLETA SMITH (SUPERVISOR)
(617) 541-1274
Entity
Organization
Contact information
Practice address
4137 SCOTTS MILL CT, SAUGUS, MA 01906-4551
(781) 854-8443
Mailing address
4137 SCOTTS MILL CT, SAUGUS, MA 01906-4551
(781) 854-8443
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
0027685700
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027685700
MED CERTIFICATION
MA
Enumeration date
06/07/2011
Last updated
06/07/2011
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