| NPI | 1366923005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEY A SMITH Owner 508-479-5202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MA 121289) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2020-07-23 |