| NPI | 1821380106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LALILTH TISSERA Psychiatrist 781-224-3607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MA 115832) |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2011-05-05 |