| NPI | 1952054546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MANCHESTER-MILES Manager 617-249-3577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-02-02 |
| Last Update Date | 2025-02-05 |