| NPI | 1962577007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH SIBLEY SACCHI Fee For Service Clinician 508-620-0010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MA 4883) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2020-08-22 |