| NPI | 1548449077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC TIBERI COO 617-521-6708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: MA 4140) |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2007-11-01 |