| NPI | 1033257522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CHRISTIAN JEPSON Clinical Social Worker 617-971-3147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health (Licence: MA 214205) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |