Healthcare Provider Details

I. General information

NPI: 1548385362
Provider Name (Legal Business Name): GREATER BOSTON CHINESE GOLDEN AGE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25-31 ESSEX ST
BOSTON MA
02111-1627
US

IV. Provider business mailing address

75 KNEELAND ST SUITE 204
BOSTON MA
02111-1906
US

V. Phone/Fax

Practice location:
  • Phone: 617-542-7458
  • Fax: 617-542-2110
Mailing address:
  • Phone: 617-357-0226
  • Fax: 617-426-8946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateMA

VIII. Authorized Official

Name: MRS. RUTH C. MOY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 617-357-0226