| NPI | 1063549962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE GLORIEUX VP Of Finance 617-524-3116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MA 1475185) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: MA 4636) | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2018-03-17 |