Organization
SUPPORTIVE BEHAVIORAL CARE OF MA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAPHAEL LICHTSCHEIN (PRESIDENT)
(718) 298-4375
Entity
Organization
Contact information
Practice address
44 SCHOOL ST, SUITE 325, BOSTON, MA 02108-4201
(718) 298-4375
Mailing address
14 SHEMEN ST, LAKEWOOD, NJ 08701-3662
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
03/23/2017
Last updated
03/23/2017
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