Organization
WAYSIDE YOUTH AND FAMILY SUPPORT NETWROK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE S HENRIQUEZ B.A (YOUTH SUPPORT WORKER)
(781) 891-0556
Entity
Organization
Contact information
Practice address
118 CENTRAL ST, WALTHAM, MA 02453-5465
(781) 891-0556
Mailing address
118 CENTRAL ST, WALTHAM, MA 02453-5465
(781) 891-0556
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/10/2007
Last updated
08/22/2020
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