| NPI | 1225614548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL CLERVILLE Director 508-326-0496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 251E00000X Home Health |
| 251J00000X Nursing Care | |
| 253Z00000X In Home Supportive Care | |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2021-03-18 |