| NPI | 1659696102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN E LONG Owner 781-374-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2010-03-27 |
| Last Update Date | 2011-11-09 |