| NPI | 1205369204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY JACOBS Clinical Director 617-935-1086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MA 1021128) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2017-04-06 |