| NPI | 1962528968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN IANDOLI Administrator 508-248-5136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: MA 1059) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |