| NPI | 1174246946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD JUSTIN ETLING CEO 781-389-5579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2023-04-05 |