| NPI | 1083253868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA SMITH Owner 617-299-1043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2019-12-27 |