| NPI | 1902116387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HORACE SHORT Clinician 617-983-0351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MA 543) |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2010-10-19 |