| NPI | 1164806295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM H SPRAGU Executive Director 617-371-3003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MA S73597186) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2015-07-18 |