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Organization
THE COMMONWEALTH OF MASSACHUSETTS
Active
Organization
THE COMMONWEALTH OF MASSACHUSETTS
Active
Parent organization
THE COMMONWEALTH OF MASSACHUSETTS
Other names
Lemuel Shattuck Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE COMMONWEALTH OF MASSACHUSETTS
Authorized official
VALENDA LIPTAK (BUREAU DIRECTOR, PUBLIC HEALTH HOSP)
(413) 784-9186
Entity
Organization
Contact information
Practice address
170 MORTON STREET, JAMAICA PLAIN, MA 02130-3735
(617) 522-8110
(617) 971-3850
Mailing address
170 MORTON STREET, JAMAICA PLAIN, MA 02130-3735
(617) 522-8110
(617) 971-3850
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
—
—
281P00000X
Chronic Disease Hospital
—
—
282E00000X
Long Term Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110078189D
—
MA
05
—
1201018
—
MA
Enumeration date
11/02/2006
Last updated
03/28/2022
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