| NPI | 1841000767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILSON KISAMBIRA KISAMBIRA Manager 781-309-8976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 320700000X Residential Treatment Facility, Physical Disabilities |
| Enumeration Date | 2025-01-13 |
| Last Update Date | 2025-01-13 |