Provider Demographics
NPI:1962129627
Name:MASSACHUSETTS CENTER FOR ADDICTION LLC
Entity type:Organization
Organization Name:MASSACHUSETTS CENTER FOR ADDICTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-245-8954
Mailing Address - Street 1:400A FRANKLIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-5524
Mailing Address - Country:US
Mailing Address - Phone:855-732-4842
Mailing Address - Fax:
Practice Address - Street 1:1515 HANCOCK ST STE 300
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5243
Practice Address - Country:US
Practice Address - Phone:855-732-4842
Practice Address - Fax:781-987-7200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-24
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility