Healthcare Provider Details
I. General information
NPI: 1831306083
Provider Name (Legal Business Name): ROXBURY COMPREHENSIVE COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
435 WARREN ST
ROXBURY MA
02119-1833
US
IV. Provider business mailing address
435 WARREN ST
ROXBURY MA
02119-1833
US
V. Phone/Fax
- Phone: 617-442-7400
- Fax:
- Phone: 617-442-7400
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANITA
L.
CRAWFORD
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 617-442-7400