| NPI | 1811024367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL M MILLS Data Application Specialist 781-586-8505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 174200000X Meals | |
| 311ZA0620X Custodial Care Facility Adult Care Home | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2025-08-04 |