MEDICARE: BOSTON HEALTH CARE SYSTEMS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1174688741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOSTON HEALTH CARE SYSTEMS, INC.

Provider Business Mailing Address
First Line	:	1865 OLD HUDSON RD
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55119-4308
Country	:	US
Telephone Number	:	651-501-2378
Fax Number	:	651-738-1737

Provider Business Practice Location Address
First Line	:	1865 OLD HUDSON RD
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55119-4308
Country	:	US
Telephone Number	:	651-501-2378
Fax Number	:	651-738-1737

Authorized Official
Title or Position	:	CEO
Name	:	MRS. MICHELE K. BOSTON
Credential	:
Telephone Number	:	651-501-2378

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	08/22/2020

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