| NPI | 1558522391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD ALLEN GENDREAU Owner 508-347-5403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MA 6609) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2008-06-24 |