| NPI | 1104491406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA MARIE HOLICK Child Outpatient Intern 508-889-0946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-05-20 |