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Organization
FENWAY COMMUNITY HEALTH CENTER, INC
Active
Organization
FENWAY COMMUNITY HEALTH CENTER, INC
Active
Parent organization
FENWAY COMMUNITY HEALTH CENTER INC
Other names
Sidney Borum Jr. Health Center of Fenway Health
Organization subpart
Yes
Provider details
NPI number
Legal business name
FENWAY COMMUNITY HEALTH CENTER INC
Authorized official
MR. JEFFREY M LIEBERMAN (VP FINANACE & ADMINISTRATION)
(617) 927-6173
Entity
Organization
Contact information
Practice address
75 KNEELAND ST, 2ND FLOOR, BOSTON, MA 02111-1901
(617) 457-8140
(617) 457-8141
Mailing address
1340 BOYLSTON ST, BOSTON, MA 02215-4302
(617) 927-6173
(617) 927-5410
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
4519
MA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
4519
MA
Other
Enumeration date
05/24/2010
Last updated
09/11/2013
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