| NPI | 1588245948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANISE PEREZ Nurse Practitioner 508-266-0999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-04-17 |
| Last Update Date | 2023-09-25 |