PINE STREET INN INC. NPI 1639337280

NPI Information

PINE STREET INN, INC. is a residential treatment facility physical disabilities in Dorchester Center, MA. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently. PINE STREET INN, INC. NPI is 1639337280. The provider is registered as an organization entity type.

The provider's business location address is:

28 ROCKWELL ST
DORCHESTER CENTER, MA
ZIP 02124-438
Phone: (617) 892-8802
Fax: (617) 825-9020

The provider's authorized official is Terrence B Gagne .
The authorized official title is Chief Financial Officer and has the following contact phone number (617) 892-9116.

The enumeration date for this NPI number is 5/30/2008 and was last updated on 5/30/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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