| NPI | 1871228205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLGA GOREA Clinical Director 617-767-1411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2022-07-20 |
| Last Update Date | 2024-07-02 |