| NPI | 1982995197 |
|---|---|
| Doing Business As | FENWAY SOUTH END |
| Entity Type | Organization |
| Authorized Contact | JEFFREY M LIEBERMAN VP Finance & Administration 617-927-6173 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: MA 4519) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2011-07-08 |