| NPI | 1346808904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACI MAURIE PATCH Executive Assistant 774-294-5722 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2019-05-30 |