| NPI | 1952836546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE VENDETTI Co Owner 774-412-3306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MA 114012) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2024-03-19 |