# FENWAY COMMUNITY HEALTH CENTER, INC

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- **Entity:** Organization
- **Status:** 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:** 1548589047
- **Legal business name:** FENWAY COMMUNITY HEALTH CENTER INC
- **Authorized official:** MR. JEFFREY M LIEBERMAN (VP FINANACE & ADMINISTRATION)
- **Authorized official phone:** (617) 927-6173

## Contact information

- **Practice address:** 75 KNEELAND ST, 2ND FLOOR, BOSTON, MA 02111-1901
- **Practice address phone:** (617) 457-8140
- **Practice address fax:** (617) 457-8141
- **Mailing address:** 1340 BOYLSTON ST, BOSTON, MA 02215-4302
- **Mailing address phone:** (617) 927-6173
- **Mailing address fax:** (617) 927-5410

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 4519 | MA | Yes |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | 4519 | MA | — |

## Other

- **Enumeration date:** 05/24/2010
- **Last updated:** 09/11/2013