| NPI | 1205080355 | 
|---|---|
| Other Name | PINE STREET INN - WOMEN'S CLINIC | 
| Entity Type | Organization | 
| Authorized Contact | AGNES W LEUNG Chief Financial Officer 857-654-1200  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: MA 4LQX)  | 
| Enumeration Date | 2008-11-14 | 
| Last Update Date | 2018-05-29 |