| NPI | 1801087580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY MICHAEL AYKROYD Idhs 617-223-3121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |