| NPI | 1982089199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE JOCHIM Site Director 508-564-9626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MA 117016) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2015-07-29 |