| NPI | 1689036790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FABIAN M WILLIAMS-GLENN Therapeutic Mentor 508-928-5389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2016-03-28 |