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General NPI Number Information
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NPI Number | 1396271748
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Entity Type | Organization
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Legal Business Name | ACRA CARE AND RECOVERY ASSOCIATES, LLC
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Dates
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Enumeration Date | 05/04/2017
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Last Update Date | 05/08/2017
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Provider Practice Location Address
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Address Line | 529 MAIN STREET, SUITE 217 THE SCHRAFFTS BUILDING, POWER HOUSE
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City | CHARLESTOWN
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State | MA
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Zip | 02129
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Country | US
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Telephone | 410-707-5856
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Fax |
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Provider Business Mailing Address
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Address Line | 69 NEWBURG ST
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City | ROSLINDALE
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State | MA
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Zip | 02131-2825
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Country | US
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Telephone | 410-707-5856
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH I. ACRA
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Credential | M.D.
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Telephone | 410-707-5856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 81453
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License Number State | MA
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