| NPI | 1902165285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS OSCAR SUNESON Therapeutic Mentor 508-324-1060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MA s47875271) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2012-05-08 |