| NPI | 1629436662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANJALEE SRIRAM NIRGUDKAR Director 617-877-9757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NJ 1-09-5526) |
| Enumeration Date | 2016-02-05 |
| Last Update Date | 2016-02-05 |