| NPI | 1811160765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NASIR A KHAN Owner 617-527-0239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MA 31809) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: MA 31809) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2008-04-10 |