| NPI | 1003557943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA NASHAWATY Program Director 617-690-9020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-04-05 |