| NPI | 1386303980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN BLACK Health Agent 508-393-5009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center Public Health, State or Local |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2021-12-10 |