| NPI | 1245691203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY T VENTURA Owner 508-243-9331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MA 7326) |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2016-06-07 |