Organization
HOLYOKE CAPITAL JV, LLC
Active
Organization
HOLYOKE CAPITAL JV, LLC
Active
Other names
MiraVista Behavioral Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL KRUPA ED.D. (CEO)
(978) 615-5200
Entity
Organization
Contact information
Practice address
1233 MAIN ST, HOLYOKE, MA 01040-5381
(413) 701-2600
Mailing address
85 PATTON RD, DEVENS, MA 01434-4401
(978) 877-9938
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Enumeration date
03/22/2021
Last updated
11/15/2021
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