| Codman Square Health Center | |
|
637 Washington St Dorchester Center MA 02124-3510 | |
| (617) 825-9660 | |
| Not Available |
| Full Name | Codman Square Health Center |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 637 Washington St, Dorchester Center, Massachusetts |
| Authorized Official Name and Position | Jaiqi Tao (CFO) |
| Authorized Official Contact | 6178259660 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Codman Square Health Center 637 Washington St Dorchester Center MA 02124-3510 Ph: () - | Codman Square Health Center 637 Washington St Dorchester Center MA 02124-3510 Ph: (617) 825-9660 |
| NPI Number | 1801099346 |
|---|---|
| Provider Enumeration Date | 06/11/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801099346 | NPI | - | NPPES |
| 1211757 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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