Organization
FRIENDS OF THE SHATTUCK SHELTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBORAH PUTNAM MPH, MSW (DIRECTOR OF PROGRAM DEVELOPMENT)
(617) 983-0351
Entity
Organization
Contact information
Practice address
170 MORTON ST, JAMAICA PLAIN, MA 02130-3735
(617) 983-0351
(617) 971-9339
Mailing address
170 MORTON ST, JAMAICA PLAIN, MA 02130-3735
(617) 983-0351
(617) 971-9339
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0796
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000020458
BMC HEALTHNET
MA
01
—
1028790
BEACON HEALTH STRATEGIES
MA
01
—
1302311
VALUE OPTIONS (MBHP)
MA
05
—
1302311
—
MA
Enumeration date
02/12/2007
Last updated
08/22/2020
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