| NPI | 1750654315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE BALOGNA Intern 978-373-1126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2012-02-13 |