Sidney Borum Jr. Health Center Of Fenway Health
LBN: Fenway Community Health Center, Inc
Sidney Borum Jr. Health Center Of Fenway Health is an health care organization with primary practice located at 75 Kneeland St 2Nd Floor, Boston MA 02111-1901. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Community Health, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center). Ambulatory Health Care Facilities / Community Health is the primary health care specialty.
Fenway Community Health Center, Inc can be contacted via phone (617) 457-8140, or through Lieberman, Jeffrey M via phone (617) 927-6173.
Contact Information
Primary practice address
75 Kneeland St 2Nd Floor
Boston MA 02111-1901
Phone: (617) 457-8140
Fax: (617) 457-8141
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Ambulatory Health Care Facilities / Community Health | 261QC1500X | 4519 | Massachusetts |
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) | 261QM0801X | 4519 | Massachusetts |
Profile Details
NPI number | 1548589047 |
---|---|
LBN Legal business name | Fenway Community Health Center, Inc |
DBA Doing business as | Sidney Borum Jr. Health Center Of Fenway Health |
Authorized official | Lieberman, Jeffrey M |
Entity | Organization |
Organization subpart 1 | Yes |
Enumeration date | May 24th, 2010 |
Last updated | Sep 11th, 2013 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1548589047 | NPPES |
Massachusetts | MEDICAID | 110024430F |
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