| The Child And Family Wellness Center | |
|
695 Truman Parkway Suite #201-202 Boston MA 02136 | |
| (888) 763-7272 | |
| (877) 243-2959 |
| Full Name | The Child And Family Wellness Center |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 695 Truman Parkway, Boston, Massachusetts |
| Authorized Official Name and Position | Edwinna Jean Wynn (CHIEF EXECUTIVE OFFICER, DIRECTOR) |
| Authorized Official Contact | 8887637272 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Child And Family Wellness Center 695 Truman Parkway Suite #201-202 Boston MA 02136 Ph: (888) 763-7272 | The Child And Family Wellness Center 695 Truman Parkway Suite #201-202 Boston MA 02136 Ph: (888) 763-7272 |
| NPI Number | 1912412172 |
|---|---|
| Provider Enumeration Date | 12/11/2017 |
| Last Update Date | 10/30/2022 |
| Certification Date | 10/30/2022 |
| Medicare PECOS PAC ID | 9436527868 |
|---|---|
| Medicare Enrollment ID | O20221116001352 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912412172 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Ludger Labissiere |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366796070 PECOS PAC ID: 7012205446 Enrollment ID: I20161018000685 |
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