Healthcare Provider Details

I. General information

NPI: 1447097233
Provider Name (Legal Business Name): URBAN GUILD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 07/10/2024
Certification Date: 07/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 WASHINGTON ST
DORCHESTER MA
02121-3907
US

IV. Provider business mailing address

260 WASHINGTON ST
DORCHESTER MA
02121-3907
US

V. Phone/Fax

Practice location:
  • Phone: 877-797-7938
  • Fax:
Mailing address:
  • Phone: 877-797-7938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: JHANA SENXIAN
Title or Position: CEO
Credential:
Phone: 877-797-7938