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Mr. Kevin James Moyer-wilkes, MED,NCC
Emotionally Disturbed Childrens' Residential Treatment Facility in Boylston, Massachusetts
NPI 1851639488

Kevin James Moyer-wilkes is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Worcester, MA. Kevin James Moyer-wilkes practices in Boylston, MA and has the professional credentials of MED,NCC. The NPI Number for Kevin James Moyer-wilkes is 1851639488 and holds a License No. 463166 (Massachusetts).

The current practice location address for Kevin James Moyer-wilkes is 1 Elmwood Pl, Boylston, MA and can be reached out via phone at 508-869-0197 and via fax at 508-869-0313.

Location: 1 Elmwood Pl, Boylston, MA, 01602-1522
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1851639488
Provider Name
Kevin James Moyer-wilkes
Credential
MED,NCC
Provider Entity Type
Individual
Gender
Male
Address
1 Elmwood Pl, Boylston, MA, 01602-1522
Phone Number
508-869-0197
Fax Number
508-869-0313
Provider Enumeration Date
01/16/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1 Elmwood Pl
City
Boylston
State
Massachusetts
Zip
01505-2040
Phone Number
508-869-0197
Fax Number
508-869-0313
person
Provider Business Mailing Address Details
Address
1 Elmwood Pl
City
Boylston
State
Massachusetts
Zip
01505-2040
Phone Number
508-869-0197
Fax Number
508-869-0313
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
School
Taxonomy
101YS0200X
License No.
C062011002701 (Connecticut)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
322D00000X
License No.
463166 (Massachusetts)
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
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