Revidas, Llc | |
108 Grove St Ste Ll11 Worcester MA 01605-2651 | |
(508) 304-7499 | |
Not Available |
Full Name | Revidas, Llc |
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Speciality | Counselor - Mental Health |
Location | 108 Grove St Ste Ll11, Worcester, Massachusetts |
Authorized Official Name and Position | Christina Y Stanley-martinez (CLINICAL DIRECTOR) |
Authorized Official Contact | 5083047499 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Revidas, Llc 108 Grove St Ste Ll11 Worcester MA 01605-2651 Ph: (508) 304-7499 | Revidas, Llc 108 Grove St Ste Ll11 Worcester MA 01605-2651 Ph: (508) 304-7499 |
NPI Number | 1528410610 |
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Provider Enumeration Date | 07/12/2016 |
Last Update Date | 08/01/2016 |
Identifier | Type | State | Issuer |
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1528410610 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | 3875 (Massachusetts) | Primary |
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