| NPI | 1285685941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN MARY DES LOGES Nurse Practitioner 1781-687-4923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 284300000X Special Hospital (Licence: MA 138951) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2020-08-22 |