| NPI | 1780201210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIANA SOLANO Member 508-348-4348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2020-06-30 |
| Last Update Date | 2020-06-30 |