| NPI | 1417263575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE J PAQUETTE Program Director 508-667-4158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MA 251S00000X) |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2010-08-27 |