| NPI | 1194532887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES SPOSATO Chief Administrative Officer 617-249-3557 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-12-16 |
| Last Update Date | 2025-09-15 |