| Granada House, Inc. | |
|
70 Adamson St Allston MA 02134-1306 | |
| (617) 254-2923 | |
| (617) 787-3820 |
| Full Name | Granada House, Inc. |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 70 Adamson St, Allston, Massachusetts |
| Authorized Official Name and Position | Vijay Dalal (PRESIDENT/CEO) |
| Authorized Official Contact | 6172542923 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Granada House, Inc. 70 Adamson St Allston MA 02134-1306 Ph: (617) 254-2923 | Granada House, Inc. 70 Adamson St Allston MA 02134-1306 Ph: (617) 254-2923 |
| NPI Number | 1275032369 |
|---|---|
| Provider Enumeration Date | 02/05/2018 |
| Last Update Date | 10/22/2021 |
| Certification Date | 10/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275032369 | NPI | - | NPPES |
| 0269 | Other | MA | RESIDENTIAL REHABILITATION SERVICES LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 0269 (Massachusetts) | Primary |
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