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 |