Provider Demographics
NPI:1538640701
Name:JUSTICE RESOURCE INSTITUTE
Entity Type:Organization
Organization Name:JUSTICE RESOURCE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COUTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-672-6560
Mailing Address - Street 1:789 STEVENS RD
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-4711
Mailing Address - Country:US
Mailing Address - Phone:508-672-6560
Mailing Address - Fax:508-672-6595
Practice Address - Street 1:789 STEVENS RD
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-4711
Practice Address - Country:US
Practice Address - Phone:508-672-6560
Practice Address - Fax:508-672-6595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health