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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
261QP2300X
Primary Care Clinic/Center
281P00000X
Chronic Disease Hospital
282E00000X
Long Term Care Hospital
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110078189C
MA
05
9780319
MA
Enumeration date
11/28/2006
Last updated
03/28/2022
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