| NPI | 1548663875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN BENSON Chief Financial Officer 508-559-6699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: MA 4896) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2018-05-30 |