| NPI | 1083230288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVERETT DICKERSON Executive Director 617-233-5404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2024-02-15 |