| NPI | 1659053072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEEMA GUPTA Member 978-390-0582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 261QM2500X Clinic/Center Medical Specialty | |
| Enumeration Date | 2023-08-04 |
| Last Update Date | 2023-08-04 |