| NPI | 1861138778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI FOWLE Owner 978-998-5663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2022-05-12 |