| NPI | 1255929824 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | LEAH DITTMAN Licensed Mental Health Counselor 774-231-8757  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health | 
| Enumeration Date | 2021-01-08 | 
| Last Update Date | 2021-01-08 |