| NPI | 1528410610 |
|---|---|
| Doing Business As | REVIDAS |
| Entity Type | Organization |
| Authorized Contact | GEOFFREY CUSHNER Managing Director 508-304-7499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 3875) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2024-10-01 |