| NPI | 1912023920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY MORIN Administrator 508-226-8616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: MA 1017) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |