| NPI | 1033611520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE REILLY GAMBELL Managing Member 781-427-6146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MA 118888) |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2018-03-01 |