| NPI | 1700475381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA M DONAHUE Clinical Social Worker 978-307-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2021-01-18 |
| Last Update Date | 2021-01-18 |