NPI | 1376334680 |
---|---|
Entity Type | Organization |
Authorized Contact | NZINGA AJABU HARRISON Owner 617-419-0858 |
Organization Subpart ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
2084P0800X Psychiatry & Neurology, Psychiatry | |
2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
Enumeration Date | 2025-05-15 |
Last Update Date | 2025-07-22 |