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General NPI Number Information
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NPI Number | 1851561120
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Entity Type | Organization
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Legal Business Name | WILD ACRE INNS, INC.
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Dates
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Enumeration Date | 03/03/2008
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 108 PLEASANT ST
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City | ARLINGTON
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State | MA
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Zip | 02476-8138
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Country | US
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Telephone | 781-643-0643
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Fax | 781-648-2859
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Provider Business Mailing Address
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Address Line | 108 PLEASANT ST
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City | ARLINGTON
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State | MA
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Zip | 02476-8138
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Country | US
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Telephone | 781-643-0643
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Fax | 781-648-2859
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Authorized Official
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Title or Position | DIRECTOR OF ADMISSIONS/UTILIZATION
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Name | JENNIFER MARIE FINCH
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Credential | LMHC,LADC1
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Telephone | 781-643-0643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | BMS007
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License Number State | MA
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