| NPI | 1790596237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH ANN NAKLICKI Billing Manager 781-937-5244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health |
| Additional Taxonomies | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2025-01-15 |
| Last Update Date | 2025-01-15 |