| Wayside Youth and Family | |
|
20 Kenmore Rd Malden MA 02148-1407 | |
| (781) 971-7331 | |
| Not Available |
| Full Name | Wayside Youth and Family |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 20 Kenmore Rd, Malden, Massachusetts |
| Authorized Official Name and Position | Samara Volodin Muniz (CEO) |
| Authorized Official Contact | 7814621701 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayside Youth and Family 20 Kenmore Rd Malden MA 02148-1407 Ph: (781) 971-7331 | Wayside Youth and Family 20 Kenmore Rd Malden MA 02148-1407 Ph: (781) 971-7331 |
| NPI Number | 1205721578 |
|---|---|
| Provider Enumeration Date | 06/09/2025 |
| Last Update Date | 06/09/2025 |
| Certification Date | 06/09/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205721578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (NU) | Primary |
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