| NPI | 1225299258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROXANNE MARTINS Clinician 508-324-1006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MA 5976) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2008-06-23 |