NPI | 1144986803 |
---|---|
Entity Type | Organization |
Authorized Contact | SHIANNE GRACE Owner 508-292-6730 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
363LF0000X Nurse Practitioner Family | |
Enumeration Date | 2021-11-16 |
Last Update Date | 2023-11-30 |