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NPI Code Detail

MEDICARE: SOUTHWEST BOSTON SENIOR SERVICES, INC.

MEDICARE: SOUTHWEST BOSTON SENIOR SERVICES, 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
1305S00000XPoint of Service

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295869089
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHWEST BOSTON SENIOR SERVICES, INC.
Provider Business Mailing Address
First Line : 555 AMORY ST
Second Line :
City : JAMAICA PLAIN
State : MA
Zip : 02130-2652
Country : US
Telephone Number : 617-522-6700
Fax Number : 617-524-2899
Provider Business Practice Location Address
First Line : 555 AMORY ST
Second Line :
City : JAMAICA PLAIN
State : MA
Zip : 02130-2652
Country : US
Telephone Number : 617-522-6700
Fax Number : 617-524-2899
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. DALE P. MITCHELL
Credential :
Telephone Number : 617-522-6700
Provider Enumeration Date : 03/15/2007
Last Update Date : 08/22/2020

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Directions to “SOUTHWEST BOSTON SENIOR SERVICES, INC. ” Practice Location

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