| NPI | 1558142752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN BRADY Administrator 508-927-1105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2024-07-18 |