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General NPI Number Information
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NPI Number | 1295169977
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Entity Type | Organization
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Legal Business Name | BOSTON NUTRITION CARE
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Dates
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Enumeration Date | 08/29/2013
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Last Update Date | 08/29/2013
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Provider Practice Location Address
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Address Line | 51 NEPONSET AVE
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City | DORCHESTER
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State | MA
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Zip | 02122-3321
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Country | US
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Telephone | 781-929-9462
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Fax |
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Provider Business Mailing Address
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Address Line | 51 NEPONSET AVE
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City | DORCHESTER
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State | MA
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Zip | 02122-3321
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Country | US
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Telephone | 781-929-9462
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. TRANG H NGUYEN
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Credential |
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Telephone | 781-929-9462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State | MA
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