| NPI | 1457704116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAMTA BHAKTA Clinical Director 617-442-1499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |