| NPI | 1053208710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA TERRANOVA Program Manager 617-291-9224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2025-06-23 |
| Last Update Date | 2025-06-23 |