| NPI | 1184963993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACI MAURIE PATCH Executive Assistant 774-294-5722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103K00000X Behavior Analyst | |
| 1041C0700X Social Worker Clinical | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2013-02-14 |
| Last Update Date | 2023-10-24 |