Organization
RIVERSIDE COMMUNITY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEDAR GRACE THOMAS LCSW (SOCIAL WORKER)
(617) 629-3919
Entity
Organization
Contact information
Practice address
61 MEDFORD ST, SOMERVILLE, MA 02143-3421
(617) 629-3919
Mailing address
61 MEDFORD ST, SOMERVILLE, MA 02143-3421
(617) 629-3919
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
07/16/2008
Last updated
10/26/2010
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