| 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 |