| NPI | 1093260101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MINDY MILLER Director Of Outpatient Services 617-770-9690 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MA 4372) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2024-07-11 |