| NPI | 1730684275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LEE HOULIHAN Excutive Assistant 508-477-7090 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: MA 4WAE) |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2018-03-27 |