| NPI | 1477919470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAXWELL SHARKEY Clinician 774-641-1404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MA 221190) |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2016-01-06 |