| Organization Name: | WAYSIDE YOUTH & FAMILY SUPPORT NETWORK |
| NPI Number: | 1669690467 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ERIC L MASI (CEO) |
| Mailing Address: | 118 Central St Waltham |
| State: | MA US |
| Postal Code: | 024535465 |
| Phone Number: | 7818910556 |
| Fax Number: | |
| NPI Enumeration Date: | 04/24/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251V00000X |
| License Number: | 0592 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Voluntary or Charitable |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |