Organization
BOSTON PSYCHIATRIC CARE LLC
Active
Other names
Boston Psychiatric Care
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE MARIE FEDOROV RN CNS (CLINICAL NURSE SPECIALIST)
(617) 830-1644
Entity
Organization
Contact information
Practice address
11 GREEN ST, JAMAICA PLAIN, MA 02130-2588
(617) 830-1644
(617) 830-1644
Mailing address
11 GREEN ST, JAMAICA PLAIN, MA 02130-2588
(617) 830-1644
(617) 830-1644
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
271091
MA
261QM0850X
Adult Mental Health Clinic/Center
Primary
271091
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811189210
INDIVIDUAL NPI NUMBER FOR DANIELLE MARIE FEDOROV RN CNS
MA
Enumeration date
08/12/2011
Last updated
08/19/2011
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