Organization
CHARLES RIVER COMMUNITY HEALTH, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW LOCKWOOD MULLANEY (CEO)
(617) 783-0500
Entity
Organization
Contact information
Practice address
43 FOUNDRY AVE STE 110, WALTHAM, MA 02453-8313
(781) 693-3800
(781) 693-3817
Mailing address
495 WESTERN AVE, BRIGHTON, MA 02135-1007
(781) 693-3800
(781) 693-3817
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
4157
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110024306T
—
MA
05
—
1320882
—
MA
01
—
2227002110
BCBS
MA
01
—
682536
TUFTS HEALTH PLAN - MED
MA
01
—
686893
TUFTS HEALTH PLAN
MA
01
—
903699
TUFTS HEALTH PLAN - MH
MA
01
—
M12043
BCBS MEDICAL/PODIATRY
MA
01
—
W20419
BCBS - OPTOMETRY
MA
Enumeration date
09/13/2006
Last updated
04/14/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up