| Italian Home For Children Inc | |
|
1125 Centre St Jamaica Plain MA 02130-3445 | |
| (617) 524-3116 | |
| Not Available |
| Full Name | Italian Home For Children Inc |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 1125 Centre St, Jamaica Plain, Massachusetts |
| Authorized Official Name and Position | Marie Glorieux (VP OF FINANCE) |
| Authorized Official Contact | 6175243116 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Italian Home For Children Inc 1125 Centre St Jamaica Plain MA 02130-3445 Ph: (617) 524-3116 | Italian Home For Children Inc 1125 Centre St Jamaica Plain MA 02130-3445 Ph: (617) 524-3116 |
| NPI Number | 1063549962 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 9032347224 |
|---|---|
| Medicare Enrollment ID | O20170117001509 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063549962 | NPI | - | NPPES |
| 1899929 | Medicaid | MA | |
| F47287 | Other | MA | NETWORK HEALTH |
| 1019890 | Other | MA | BEACON HEALTH OPTIONS (NOT STRATEGIES) |
| 110032625 | Other | MA | MASSHEALTH |
| Provider Name | Yota L Gikas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619002086 PECOS PAC ID: 3577791458 Enrollment ID: I20140123000497 |
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