| NPI | 1396047353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE K JEAN General Duty RN 617-665-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MA 264807) |
| Enumeration Date | 2010-11-24 |
| Last Update Date | 2010-11-24 |