| NPI | 1730897299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BORIS GOLOSARSKY Director 781-367-4650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 207RA0401X Internal Medicine Addiction Medicine |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2022-11-14 |