| NPI | 1538443205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADELINE PENALOZA Nurse 617-238-5361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2022-07-21 |