| NPI | 1346968021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY MUTHONI NDUNGU Pmhnp Bc 508-615-7980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2022-08-18 |
| Last Update Date | 2022-08-18 |