| NPI | 1386280535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN WAITNEIGHT Practice Owner 617-686-9802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2019-11-22 |