| NPI | 1508136177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT RALPH MADARUSO Clinical Director 617-265-2636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MA 1697) |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2012-01-12 |