| NPI | 1770131252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE JACOBS Owner 617-823-0899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2026-07-21 |