| NPI | 1609996784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLENE DIGGS-LASSETER Clinic Administrator 508-968-6733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-08-22 |