| NPI | 1376027102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL L PEDRICK Owner 617-233-0124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2018-09-18 |