| NPI | 1851797542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY J ROACH Chief Operating Officer 617-426-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2014-11-07 |