| NPI | 1649856618 |
|---|---|
| Doing Business As | MIRAVISTA BEHAVIORAL HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | MICHAEL KRUPA CEO 978-615-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital |
| Additional Taxonomies | 261QM2800X Clinic/Center Methadone |
| 276400000X Rehabilitation, Substance Use Disorder Unit | |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2021-11-15 |