| NPI | 1164590634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARA SUSANNE DEJONG Registered Dietitian 617-732-5577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MA 2417) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2020-08-22 |