| NPI | 1750938171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW GANEM Owner, Operator 617-435-9783 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2019-08-20 |