Healthcare Provider Details

I. General information

NPI: 1730208638
Provider Name (Legal Business Name): HANCOCK PARK LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 PARKINGWAY ST
QUINCY MA
02169-5020
US

IV. Provider business mailing address

164 PARKINGWAY ST
QUINCY MA
02169-5020
US

V. Phone/Fax

Practice location:
  • Phone: 617-773-4222
  • Fax: 617-773-1115
Mailing address:
  • Phone: 617-773-4222
  • Fax: 617-773-1115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MICHAEL WELCH
Title or Position: VICE PRESIDENT
Credential:
Phone: 781-878-6700