| NPI | 1073176129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY MCLOUGHLIN BREAULT Registered Agent 508-847-0306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2019-06-19 |