NPI | 1659387074 |
---|---|
Entity Type | Organization |
Authorized Contact | GLENN J STALGREN Business Administrator 508-693-7900 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 2331) |
101YM0800X Counselor, Mental Health (Licence: MA 2331) | |
Enumeration Date | 2006-07-31 |
Last Update Date | 2019-10-28 |