| NPI | 1508185083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY MITCHELL NIXON Clinic Director 508-587-0815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MA 120) |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2010-05-24 |