| NPI | 1114137585 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW DANIELS Director 508-375-9922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 103T00000X Psychologist |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |