Interim House INC
NPI #1508136177 in Dorchester, Massachusetts
Provider Information
- NPI Number
- 1508136177
- Entity Type
- Organization
- Organization Name
- Interim House INC
- Primary Specialty
- Substance Abuse Rehabilitation Facility
- Enumeration Date
- Jan 12, 2012
- Last Updated
- Jan 12, 2012
Practice Location
- Address
- 62 WALDECK ST
- City
- Dorchester
- State
- Massachusetts
- ZIP Code
- 02124-1329
- Phone
- (617) 265-2636
Authorized Official
- Name
- MR. ROBERT RALPH MADARUSO, LADC1
- Title
- CLINICAL DIRECTOR
- Phone
- (617) 265-2636
Specialties & Taxonomy Codes
| Specialty |
|---|
| Substance Abuse Rehabilitation Facility |
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