Organization
RADIANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBROAH FORD LADC I (OWNER)
(774) 494-2135
Entity
Organization
Contact information
Practice address
33 DOVER ST STE 313, BROCKTON, MA 02301-5973
(774) 494-2135
(339) 444-2717
Mailing address
33 DOVER ST STE 313, BROCKTON, MA 02301-5973
(774) 494-2135
(339) 444-2717
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/22/2024
Last updated
02/22/2024
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