| NPI | 1205298148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEOFFREY WHITLEY Owner 617-620-9757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 163WN1003X Registered Nurse, Nutrition Support (Licence: MA RN2267850) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA RN2267850) | |
| 101YM0800X Counselor, Mental Health | |
| 133V00000X Dietitian, Registered | |
| 225700000X Massage Therapist (Licence: MA 1099) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2267850) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2016-03-21 |
| Last Update Date | 2018-03-19 |