Organization
ITALIAN HOME FOR CHILDREN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE M LEARY (SENIOR STAFF ACCOUNTANT)
(617) 524-3116
Entity
Organization
Contact information
Practice address
77B WARREN STREET, BUILDING 2, BRIGHTON, MA 02135
(617) 787-1901
Mailing address
1125 CENTRE ST, JAMAICA PLAIN, MA 02130-3445
(617) 524-3116
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
1475185
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063549962
—
MA
05
—
1922043876
—
MA
Enumeration date
04/10/2015
Last updated
04/10/2015
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