Healthcare Provider Details

I. General information

NPI: 1174542013
Provider Name (Legal Business Name): FRANCISCAN HOSPITAL FOR CHILDREN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 WARREN ST
BOSTON MA
02135-3602
US

IV. Provider business mailing address

30 WARREN ST
BOSTON MA
02135-3602
US

V. Phone/Fax

Practice location:
  • Phone: 617-254-3800
  • Fax: 617-779-1119
Mailing address:
  • Phone: 617-254-3800
  • Fax: 617-779-1119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number2221
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code283XC2000X
TaxonomyChildren's Rehabilitation Hospital
License Number110
License Number StateMA

VIII. Authorized Official

Name: JOSEPH ALEX MITCHELL
Title or Position: PRESIDENT
Credential:
Phone: 617-779-1100