| NPI | 1255574901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY BENBOW Vice President Of Finance 617-226-5745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MA 1547) |
| Enumeration Date | 2009-04-10 |
| Last Update Date | 2009-04-10 |