Organization
HOLYOKE MMTP, LLC
Active
Other names
MiraVista Behavioral Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL KRUPA ED.D (CEO)
(978) 615-5200
Entity
Organization
Contact information
Practice address
1233 MAIN ST, HOLYOKE, MA 01040-5381
(413) 701-2600
Mailing address
85 PATTON RD, DEVENS, MA 01434-4401
(978) 615-5200
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
04/29/2021
Last updated
04/29/2021
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