| NPI | 1841200664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALYDA JUSTINIANO-FRANZEL Mgr. Provider Relations/Cred 508-860-7962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: MA 4669) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2024-05-23 |