NPI | 1952658056 |
---|---|
Entity Type | Organization |
Authorized Contact | KATHLEEN M LUISI Manager 617-913-3321 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MA DH11340) |
Enumeration Date | 2012-08-07 |
Last Update Date | 2012-08-07 |