| NPI | 1275953473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE CANTON CEO 617-368-0820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: MA 42EG) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: MA 42EG) |
| Enumeration Date | 2014-04-27 |
| Last Update Date | 2014-04-27 |