| NPI | 1649293028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN A. OSHLAG Vice President Of Operations 508-860-1163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MA 4684) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MA 2R006) |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: MA 0110) | |
| 261QC1500X Clinic/Center, Community Health (Licence: MA 4684) | |
| 251S00000X (Licence: MA 4684) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-10-25 |