Provider Demographics
NPI:1447914056
Name:FORESTA BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:FORESTA BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:MERCEDES
Authorized Official - Last Name:PINTO ZULUAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-922-4942
Mailing Address - Street 1:173 SHIRLEY ST # 4
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:MA
Mailing Address - Zip Code:02152-1144
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:173 SHIRLEY ST # 4
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:MA
Practice Address - Zip Code:02152-1144
Practice Address - Country:US
Practice Address - Phone:857-540-7523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty