| NPI | 1730453432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTY KOSKI Provider 617-470-3148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MA 7466) |
| Enumeration Date | 2012-02-28 |
| Last Update Date | 2013-05-22 |