| NPI | 1306202189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN MULLALEY Billing Manager 781-248-3390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2025-02-27 |