| NPI | 1639564214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYLA C HAMPTON Behavioral Management Therapist 774-240-1504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2015-04-01 |