| NPI | 1699300665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATHEW KIIO Practice Owner 978-770-5743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2024-04-12 |