| NPI | 1063351815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH MUTEGYEKI Director 508-306-1128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2026-03-26 |
| Last Update Date | 2026-03-26 |