| NPI | 1609385541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAITRA CHANNAPPA Staff Physician 774-343-2432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2022-07-21 |