Wayside Youth and Family Support Netwrok
NPI #1942423165 in Waltham, Massachusetts
Provider Information
- NPI Number
- 1942423165
- Entity Type
- Organization
- Organization Name
- Wayside Youth and Family Support Netwrok
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Apr 10, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 118 CENTRAL ST
- City
- Waltham
- State
- Massachusetts
- ZIP Code
- 02453-5465
- Phone
- (781) 891-0556
Authorized Official
- Name
- MS. MICHELLE S HENRIQUEZ, B.A
- Title
- YOUTH SUPPORT WORKER
- Phone
- (781) 891-0556
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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