Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Prison Health |
261QP2400X |
| NPI # | 1306701248 |
| LBN Legal business name | THE COMMONWEALTH OF MASSACHUSETTS |
| Authorized official | JASON FARO - (ASSISTANT SUPERINTENDENT) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 12/23/2025 |
| Last updated | 12/23/2025 - About 6 months ago |
| Identifiers | n/a |
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