Organization
BOSTON HEALTH CARE FOR THE HOMELESS PROGRAM, INC.
Active
Other names
Stacy Kirkpatrick House
Organization subpart
No
Provider details
NPI number
Authorized official
AGNES W LEUNG (CHIEF FINANCIAL OFFICER)
(857) 654-1200
Entity
Organization
Contact information
Practice address
461 WALNUT AVE, JAMAICA PLAIN, MA 02130
(857) 654-1550
(857) 654-1471
Mailing address
780 ALBANY ST, BOSTON, MA 02118-2755
(857) 654-1227
(857) 654-1404
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
4LQX
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110020876Q
—
MA
Enumeration date
03/30/2016
Last updated
05/25/2018
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