| NPI | 1316592199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRA STRACK Owner 617-203-8676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-08-07 |
| Last Update Date | 2020-11-11 |