| NPI | 1639553019 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE TWAROG A R Director 774-628-1033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MA 1019520) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2015-07-15 |