| NPI | 1467768812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE MIMMO Nurse Manager 508-896-5776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MA 1476468) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MA 1476466) |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MA 1476467) | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: MA 9012334) | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: MA 9012336) | |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2024-08-08 |