| NPI | 1407235286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY FISHER Program Director 508-638-6066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MA 1518996354) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-26 |