| NPI | 1336841451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN GERSON Member 781-248-3360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| 251S00000X Community/Behavioral Health | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2023-03-21 |
| Last Update Date | 2023-03-21 |