| NPI | 1114817004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIUDMILA CARDOSO Pmhnp 774-240-5585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2025-07-03 |
| Last Update Date | 2025-07-03 |