Provider First Line Business Practice Location Address:
66 CANAL ST
Provider Second Line Business Practice Location Address:
BAY COVE TREATMENT CENTER
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02114-2002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-169-5937
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2007