| NPI | 1124797931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DEBERARDINIS Director Of Ur 781-799-4350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2025-09-16 |