| NPI | 1922405232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUZ STELLA LOAIZA Social Worker 617-637-5250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MA S37025870) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2014-12-02 |