Provider First Line Business Practice Location Address:
55 FRUIT STREET, WAC037
Provider Second Line Business Practice Location Address:
MASSACHUSETTS GENERAL HOSPITAL, SOCIAL SERVICES
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-726-2000
Provider Business Practice Location Address Fax Number:
617-726-1042
Provider Enumeration Date:
11/13/2006