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General NPI Number Information
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NPI Number | 1063549962
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Entity Type | Organization
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Legal Business Name | ITALIAN HOME FOR CHILDREN INC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 1125 CENTRE ST
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-3445
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Country | US
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Telephone | 617-524-3116
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Fax |
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Provider Business Mailing Address
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Address Line | 1125 CENTRE ST
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City | JAMAICA PLAIN
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State | MA
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Zip | 02130-3445
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Country | US
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Telephone | 617-524-3116
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Fax | 857-547-1138
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Authorized Official
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Title or Position | VP OF FINANCE
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Name | MS. MARIE GLORIEUX
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Credential |
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Telephone | 617-524-3116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 4636
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 1475185
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License Number State | MA
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