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Organization

LA ALIANZA HISPANA, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROSA MARIA COLON (CONTRACT MANAGER)
(617) 427-7175
Entity
Organization

Contact information

Practice address
409 DUDLEY ST, ROXBURY, MA 02119-3366
(617) 427-7175
(617) 442-2259
Mailing address
409 DUDLEY ST, ROXBURY, MA 02119-3366
(617) 427-7175
(617) 442-2259

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1901559
MA
Enumeration date
04/12/2007
Last updated
05/04/2009
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