| NPI | 1548533789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LEON AVERY President/CEO 617-282-9772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MA 7173) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MA 572) |
| Enumeration Date | 2012-02-20 |
| Last Update Date | 2012-02-20 |