| NPI | 1700801263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE WELCH Executive Director 617-521-6703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: MA 4140) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2018-06-13 |