| NPI | 1225872187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNE BARRY Owner 774-274-3457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2024-08-23 |