| NPI | 1487101952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANELL J DILLON Tm 617-285-4124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |