Organization
PINE STREET INN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYNDIA DOWNIE (PRESIDENT AND CEO)
(617) 892-9108
Entity
Organization
Contact information
Practice address
444 HARRISON AVE, BOSTON, MA 02118-2404
(617) 892-9451
(617) 521-7621
Mailing address
444 HARRISON AVE, BOSTON, MA 02118-2404
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0817
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1300130
—
MA
Enumeration date
02/22/2007
Last updated
04/12/2012
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