| NPI | 1225085319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN BENSON CFO 508-894-3642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: MA 4896) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2018-05-03 |