Healthcare Provider Details

I. General information

NPI: 1740377985
Provider Name (Legal Business Name): JEWISH FAMILY & CHILDREN'S SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 PORTLAND ST
BOSTON MA
02114-1714
US

IV. Provider business mailing address

1430 MAIN ST
WALTHAM MA
02451-1623
US

V. Phone/Fax

Practice location:
  • Phone: 617-227-6641
  • Fax: 617-227-1190
Mailing address:
  • Phone: 781-647-5327
  • Fax: 617-693-5188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ELLEN LASH
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 617-227-6641