| NPI | 1619776846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE MILLER Manager 774-413-0723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-03-11 |
| Last Update Date | 2025-03-11 |