| NPI | 1255905576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAYWELL TEDOE Owner 508-466-5919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| 363LW0102X Nurse Practitioner Women's Health | |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2025-07-20 |