| Boston Public Health Commission | |
|
1226 Columbia Rd # A South Boston MA 02127-3978 | |
| (617) 534-9500 | |
| Not Available |
| Full Name | Boston Public Health Commission |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1226 Columbia Rd # A, South Boston, Massachusetts |
| Authorized Official Name and Position | Bisola Ojikutu (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6175345264 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boston Public Health Commission 1010 Massachusetts Ave Boston MA 02118-2600 Ph: (617) 534-5264 | Boston Public Health Commission 1226 Columbia Rd # A South Boston MA 02127-3978 Ph: (617) 534-9500 |
| NPI Number | 1205231941 |
|---|---|
| Provider Enumeration Date | 10/23/2014 |
| Last Update Date | 03/24/2022 |
| Certification Date | 03/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205231941 | NPI | - | NPPES |
| 001542402 | Other | MA | MEDICARE PTAN |
| 4YHQ | Other | MA | MENTAL HEALTH LICENSE |
| 110025617/G | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 4YHQ (Massachusetts) | Primary |
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