| NPI | 1538841374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVINIA ROOSA Director 774-220-1634 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-08-02 |
| Last Update Date | 2023-08-02 |