Provider Demographics
NPI:1851561120
Name:WILD ACRE INNS, INC.
Entity Type:Organization
Organization Name:WILD ACRE INNS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMISSIONS/UTILIZATION
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FINCH
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC,LADC1
Authorized Official - Phone:781-643-0643
Mailing Address - Street 1:108 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-8138
Mailing Address - Country:US
Mailing Address - Phone:781-643-0643
Mailing Address - Fax:781-648-2859
Practice Address - Street 1:108 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-8138
Practice Address - Country:US
Practice Address - Phone:781-643-0643
Practice Address - Fax:781-648-2859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MABMS007320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA92593OtherCIGNA
MA024990OtherVALUE OPTIONS
MA1005680OtherBEACON HEALTH STRATEGIES
MA1005680OtherBEACON HEALTH STRATEGIES
MA=========OtherMAGELLAN