Organization
MATTAPAN COMMUNITY HEALTH CENTER INC
Active
Other names
FQHC Facility
Organization subpart
No
Provider details
NPI number
Authorized official
GUALE VALDEZ (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(617) 898-9090
Entity
Organization
Contact information
Practice address
1575 BLUE HILL AVE, MATTAPAN, MA 02126-2122
(617) 296-0061
(617) 296-5408
Mailing address
1575 BLUE HILL AVE, MATTAPAN, MA 02126-2122
(617) 296-0061
(617) 296-5408
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1301438
—
MA
Enumeration date
11/13/2006
Last updated
04/29/2019
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