NPI | 1265050736 |
---|---|
Entity Type | Organization |
Authorized Contact | NZINGA AJABU HARRISON Chief Medical Officer & Owner 617-419-0858 |
Organization Subpart ? | No |
Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
207QA0401X Family Medicine, Addiction Medicine | |
2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
Enumeration Date | 2020-07-10 |
Last Update Date | 2021-02-10 |