| NPI | 1902410640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH GERENA Clinical Director 617-655-9808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2020-09-01 |