| NPI | 1174542013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH ALEX MITCHELL President 617-779-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 283XC2000X Rehabilitation Hospital, Children (Licence: MA 110) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: MA 2221) |
| 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2024-03-22 |