| NPI | 1245415520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE ANDREA WAHBA Sole Member 508-791-9340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MA 8302) |
| Additional Taxonomies | 251S00000X (Licence: MA 5545) |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2008-01-04 |