| NPI | 1003981903 |
|---|---|
| Doing Business As | THE LONGFELLOW CLUB |
| Entity Type | Organization |
| Authorized Contact | JANE POLLEY Dietitian 508-358-7355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2015-06-09 |