1336382944 NPI number — BOSTON HEALTH CARE FOR THE HOMELESS PROGRAM, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336382944 NPI number — BOSTON HEALTH CARE FOR THE HOMELESS PROGRAM, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BOSTON HEALTH CARE FOR THE HOMELESS PROGRAM, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FATHER BILL'S PLACE
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336382944
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/23/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
780 ALBANY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02118-2755
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
857-654-1227
Provider Business Mailing Address Fax Number:
857-654-1404

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
38 BROAD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
QUINCY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02169
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-770-3314
Provider Business Practice Location Address Fax Number:
617-773-3146
Provider Enumeration Date:
04/13/2009

Additional Information

Authorized Official

Authorized Official Last Name:
LEUNG
Authorized Official First Name:
AGNES
Authorized Official Middle Name:
W
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
857-654-1200

Provider Taxonomy Codes

  • Taxonomy code: 261QF0400X , with the licence number:  4LQX , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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