Provider Demographics
NPI:1174760870
Name:JUSTICE RESOURCE INSTITUTE
Entity type:Organization
Organization Name:JUSTICE RESOURCE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLIICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:508-362-8606
Mailing Address - Street 1:545 BOYLSTON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-3606
Mailing Address - Country:US
Mailing Address - Phone:617-450-0500
Mailing Address - Fax:
Practice Address - Street 1:3195 MAIN ST
Practice Address - Street 2:
Practice Address - City:BARNSTABLE
Practice Address - State:MA
Practice Address - Zip Code:02630-1105
Practice Address - Country:US
Practice Address - Phone:508-362-8606
Practice Address - Fax:508-362-0046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4703251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management