Organization
HOPE ADULT GROUP HOME
Active
Other names
Hope Adult Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MARIE GABRIELLE DESSALINES (COORDINATOR)
(617) 291-4353
Entity
Organization
Contact information
Practice address
96 OLIVER ST, AVON, MA 02322-1634
(617) 291-4353
Mailing address
96 OLIVER ST, AVON, MA 02322-1634
(617) 291-4353
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN262190
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
MA
Enumeration date
06/21/2018
Last updated
06/21/2018
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