| NPI | 1205900354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL PHILLIPS Division Chief 617-667-4916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MA 73356) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: MA 73356) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |