| NPI | 1053116707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN C LEVINE Owner/Founder 617-750-8311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-02-17 |