| NPI | 1508548033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK A RYAN Owner 617-787-9170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0801X |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2023-08-03 |
| Last Update Date | 2023-08-03 |