Organization
MAY INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANDREA LYNNE PHANEUF (DIRECT THERAPIST)
(508) 468-4049
Entity
Organization
Contact information
Practice address
14 PACELLA PARK DR, RANDOLPH, MA 02368-1756
(781) 437-1404
Mailing address
14 PACELLA PARK DR, RANDOLPH, MA 02368-1756
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265
—
MA
Enumeration date
03/26/2014
Last updated
03/26/2014
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