Organization
PINE STREET INN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIA IMELDA FITZPATRICK LCSW (CLINICIAN)
(617) 892-7893
Entity
Organization
Contact information
Practice address
170 MORTON ST, BOSTON, MA 02130-3735
(617) 892-7893
Mailing address
1220 ADAMS ST, G17, BOSTON, MA 02124-5752
(917) 334-2916
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
220519
MA
Other
Enumeration date
05/11/2015
Last updated
05/11/2015
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