| NPI | 1205344744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN CURTIS Credentialing Specialist 617-453-3802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA 44294) |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2018-01-18 |