| NPI | 1861435919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBIE COYLE Credentialing Manager 508-996-8572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MA 222972) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2020-08-22 |