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43 Garrison Rd Brookline MA 02445-4445 | |
| (617) 277-8107 | |
| (617) 734-6385 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 43 Garrison Rd, Brookline, Massachusetts |
| Authorized Official Name and Position | Funmi Aguocha (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 8577073481 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
43 Garrison Rd Brookline MA 02445-4445 Ph: (617) 277-8107 | 43 Garrison Rd Brookline MA 02445-4445 Ph: (617) 277-8107 |
| NPI Number | 1467745109 |
|---|---|
| Provider Enumeration Date | 05/26/2011 |
| Last Update Date | 08/22/2022 |
| Certification Date | 08/22/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467745109 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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