| NPI | 1508013632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNA CONOLE Assistant Exeutive Director 978-459-8656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MA 021426486) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2008-08-20 |