| NPI | 1326155458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONA MACKINNON Center Director 774-297-3246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2023-05-03 |