| NPI | 1558481879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE S. FANTES Chief Medical Officer 617-569-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-12-29 |