| NPI | 1093172462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELA ORSOGNA MUIR Bcba 508-455-7848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MA 1-15-18951) |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2016-01-15 |