Organization
MASSACHUSETTS CENTER FOR ADOLESCENT WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD THATCHER (CFO)
(754) 217-8127
Entity
Organization
Contact information
Practice address
639 GRANITE ST STE 402, BRAINTREE, MA 02184-5369
(603) 703-2545
Mailing address
639 GRANITE ST STE 402, BRAINTREE, MA 02184-5369
(603) 703-2545
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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