Healthcare Provider Details

I. General information

NPI: 1124481551
Provider Name (Legal Business Name): DAUGHTERS OF SAINT PAUL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2016
Last Update Date: 04/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 SAINT PAULS AVE
JAMAICA PLAIN MA
02130-3433
US

IV. Provider business mailing address

50 SAINT PAULS AVE
JAMAICA PLAIN MA
02130-3433
US

V. Phone/Fax

Practice location:
  • Phone: 617-522-8911
  • Fax: 617-524-8648
Mailing address:
  • Phone: 617-522-8911
  • Fax: 617-524-8648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MARGARET MARY MORAN
Title or Position: PROVINCIAL TREASURER
Credential: FSP
Phone: 617-522-8911