Provider First Line Business Practice Location Address:
1 PRINCE STREET
Provider Second Line Business Practice Location Address:
MASSACHUSETTS DEPARTMENT OF MENTAL HEALTH
Provider Business Practice Location Address City Name:
NORTHAMPTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01061-0389
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-587-6294
Provider Business Practice Location Address Fax Number:
413-587-6217
Provider Enumeration Date:
10/13/2006