| NPI | 1821465204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE MANYONG ENYONG Owner 617-230-4437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: TX 016973) |
| Additional Taxonomies | 251T00000X Program of All-Inclusive Care for the Elderly (PACE) Provider Organization (Licence: TX 016973) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2015-09-01 |