| NPI | 1962266205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LITMARIE REYES MELENDEZ Billing & Credentialing Analyst 978-788-8879 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2025-12-09 |