| NPI | 1821586033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE RUSSELLA POLLARD Owner 617-785-8192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MA 000009167) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2018-04-24 |