| NPI | 1477853331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA DAPONTE Program Director 508-821-1181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MA 213803) |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2010-10-26 |