| NPI | 1770634776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELEANOR J DIETHELM Social Worker 508-559-6699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MA 1029174) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |