| NPI | 1124376330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE CLAUDETTE DELMAS Clinical Social Worker 774-208-3330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2012-08-17 |