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Organization
FRIENDS OF THE SHATTUCK SHELTER
Active
Organization
FRIENDS OF THE SHATTUCK SHELTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORAH PUTNAM MPH, MSW (DIRECTOR OF PROGRAM DEVELOPMENT)
(617) 983-0351
Entity
Organization
Contact information
Practice address
170 MORTON ST, JAMAICA PLAIN, MA 02130-3735
(617) 983-0351
(617) 971-9339
Mailing address
170 MORTON ST, JAMAICA PLAIN, MA 02130-3735
(617) 983-0351
(617) 971-9339
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0796
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000020458
BMC HEALTHNET
MA
01
—
1028790
BEACON HEALTH STRATEGIES
MA
01
—
1302311
VALUE OPTIONS (MBHP)
MA
05
—
1302311
—
MA
Enumeration date
02/12/2007
Last updated
08/22/2020
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