| NPI | 1952984767 |
|---|---|
| Doing Business As | MIRAVISTA BEHAVIORAL HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | MICHAEL KRUPA CEO 978-615-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2021-04-29 |