| NPI | 1871645085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELAH ANN BROWN Outpatient Clinician 413-585-0853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MA 302f0000x) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-08-22 |