| NPI | 1033667506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON BURCH Owner 617-784-8997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 007139) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2016-09-14 |