Healthcare Provider Details

I. General information

NPI: 1699504787
Provider Name (Legal Business Name): FAMILYAID BOSTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 07/29/2024
Certification Date: 07/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 WASHINGTON ST
BOSTON MA
02130-3745
US

IV. Provider business mailing address

3815 WASHINGTON ST
BOSTON MA
02130-3745
US

V. Phone/Fax

Practice location:
  • Phone: 617-542-7286
  • Fax:
Mailing address:
  • Phone: 617-542-7286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: TRACY L WELSH
Title or Position: COO
Credential:
Phone: 857-239-5449