| NPI | 1538259866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES J STEIN Cdr 01149-951-8276 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: MA 15844) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2020-08-22 |