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General NPI Number Information
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NPI Number | 1629164975
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Entity Type | Organization
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Legal Business Name | METRO HEALTH FOUNDATION OF MASSACHUSETTS, INC.
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 337 NEPONSET AVE
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City | DORCHESTER
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State | MA
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Zip | 02122-3103
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Country | US
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Telephone | 617-265-2350
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Fax | 617-265-0577
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Provider Business Mailing Address
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Address Line | 337 NEPONSET AVE
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City | DORCHESTER
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State | MA
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Zip | 02122-3103
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Country | US
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Telephone | 617-265-2350
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Fax | 617-265-0577
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MRS. JUDITH LIMA
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Credential |
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Telephone | 781-803-7361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0794
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License Number State | MA
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