| NPI | 1023651676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN DOYLE Executive Director 774-704-5501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2020-01-14 |