| NPI | 1750035408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY TAVEIRA Owner 508-932-0241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist Psychiatric/Mental Health |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2022-02-10 |