| NPI | 1912339342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE COOK Manager 617-421-1149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MA 1337) |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2013-08-08 |