| NPI | 1104077544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK BAUER Program Director 774-826-2456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283Q00000X Psychiatric Hospital (Licence: MA 233250) |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2008-10-03 |