| NPI | 1174491369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON SUPRENANT CEO 617-733-4233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2025-10-28 |
| Last Update Date | 2025-10-28 |