| NPI | 1982840419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA DUBUQUE Biller 413-420-2208 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health (Licence: MA 4118) |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2009-01-06 |