| NPI | 1285818088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC TIBERI COO 617-521-6708 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: MA 4140) |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2007-12-28 |