| NPI | 1962990952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JOSEPH DIGIAMMARINO Manager 617-431-3990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MA 10665) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MA 10665) |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2018-04-25 |