| NPI | 1306074463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE A FISHMAN Administrative Director 617-638-4920 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2012-03-16 |