| NPI | 1588941405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN A BOATENG RN 508-854-1721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 225XP0200X Occupational Therapist Pediatrics |
| Enumeration Date | 2011-11-06 |
| Last Update Date | 2011-11-06 |