| NPI | 1164085080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANETTE SIGEL Administrative Director 781-208-0390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2025-04-02 |