| NPI | 1669293502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN TRUDEAU Owner 774-264-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) |
| Enumeration Date | 2024-10-23 |
| Last Update Date | 2025-01-21 |