Pine Street Inn, Inc.
NPI #1639337280 in Dorchester Center, Massachusetts
Provider Information
- NPI Number
- 1639337280
- Entity Type
- Organization
- Organization Name
- Pine Street Inn, Inc.
- Primary Specialty
- Residential Treatment Facility, Physical Disabilities
- Enumeration Date
- May 30, 2008
- Last Updated
- May 30, 2008
Practice Location
- Address
- 28 ROCKWELL ST
- State
- Massachusetts
- ZIP Code
- 02124-4438
- Phone
- (617) 892-8802
Authorized Official
- Name
- MR. TERRENCE B GAGNE
- Title
- CHIEF FINANCIAL OFFICER
- Phone
- (617) 892-9116
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Physical Disabilities |
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