| NPI | 1215611173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK GORMAN Chief Executive Director 781-799-0895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2023-06-12 |