| NPI | 1255630448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARIN BERNARD Credentialing Manager 978-689-6683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: MA 4943) |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2020-04-28 |