FENWAY COMMUNITY HEALTH CENTER INC NPI 1548589047

NPI Information

NPI: 1548589047
Provider Name: FENWAY COMMUNITY HEALTH CENTER, INC

Doing Business As: SIDNEY BORUM JR. HEALTH CENTER OF FENWAY HEALTH

Classification: Clinic/Center - 261QC1500X
Entity Type: Organization

Specialization: Community Health

Address:
75 KNEELAND ST
2ND FLOOR
BOSTON, MA
ZIP 02111
Phone: (617) 457-8140
Get Directions

FENWAY COMMUNITY HEALTH CENTER, INC is a community health clinic center in Boston, MA. FENWAY COMMUNITY HEALTH CENTER, INC NPI is 1548589047. The provider is registered as an organization entity type.
The provider Is Doing Business As Sidney Borum Jr. Health Center Of Fenway Health.

The provider's business location address is:

75 KNEELAND ST
2ND FLOOR
BOSTON, MA
ZIP 02111-901
Phone: (617) 457-8140
Fax: (617) 457-8141

The provider's authorized official is Jeffrey M Lieberman .
The authorized official title is Vp Finanace & Administration and has the following contact phone number (617) 927-6173.

The enumeration date for this NPI number is 5/24/2010 and was last updated on 9/11/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	4519	MASSACHUSETTS	No
2	261QC1500X	Clinic/Center	Community Health	4519	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	110024430F	MEDICAID	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »