Provider First Line Business Practice Location Address:
SOUTH BAY COMMUNITY SERVICES
Provider Second Line Business Practice Location Address:
340 MAIN STREET - SUITE 818
Provider Business Practice Location Address City Name:
WORCESTER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-234-0396
Provider Business Practice Location Address Fax Number:
508-521-2287
Provider Enumeration Date:
08/16/2017