| NPI | 1689958761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE MANUEL RIVERA Substance Abuse Clinician 617-983-0351 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: MA 101YA0400X) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2011-10-06 |