Organization
FENWAY COMMUNITY HEALTH CENTER, INC
Active
Parent organization
FENWAY COMMUNITY HEALTH CENTER, INC
Other names
Fenway South End
Organization subpart
Yes
Provider details
NPI number
Legal business name
FENWAY COMMUNITY HEALTH CENTER, INC
Authorized official
MR. JEFFREY M LIEBERMAN (VP FINANCE & ADMINISTRATION)
(617) 927-6173
Entity
Organization
Contact information
Practice address
142 BERKELEY ST, BOSTON, MA 02116-5100
(617) 247-7555
Mailing address
1340 BOYLSTON ST, BOSTON, MA 02215-4302
(617) 927-6073
(617) 927-5410
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
4519
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110020739D
—
MA
Enumeration date
04/21/2011
Last updated
07/08/2011
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