| NPI | 1649863457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN CAULFIELD Executive Director 617-504-2304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2021-02-12 |
| Last Update Date | 2021-02-12 |