| NPI | 1316120710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA MICHELLE WRIGHT Office Manager 508-563-7133 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MA 1770) |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2008-04-20 |