| NPI | 1538640701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY ANN COUTO Clinician 508-672-6560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2018-08-27 |