| NPI | 1043880883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIESHA N WILLIAMS-JEANTY Manager 617-440-4650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2024-05-02 |