| NPI | 1851055784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY R HOULE Treasurer 617-864-0941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology Addiction Psychiatry |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| Enumeration Date | 2021-10-27 |
| Last Update Date | 2022-05-09 |