| NPI | 1205216231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT IAN COHEN COO 617-790-4271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2023-03-05 |