| NPI | 1194111252 |
|---|---|
| Doing Business As | NO |
| Entity Type | Organization |
| Authorized Contact | GEORGINA NJENGA Ms Pa C 413-887-5130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: MA PA5315) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2015-04-15 |