| Charles River Community Health, Inc | |
|
495 Western Ave Brighton MA 02135-1007 | |
| (617) 783-0500 | |
| Not Available |
| Full Name | Charles River Community Health, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 495 Western Ave, Brighton, Massachusetts |
| Authorized Official Name and Position | Christel Gianci (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 6178707431 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles River Community Health, Inc 495 Western Ave Brighton MA 02135-1007 Ph: (617) 783-0500 | Charles River Community Health, Inc 495 Western Ave Brighton MA 02135-1007 Ph: (617) 783-0500 |
| NPI Number | 1114175916 |
|---|---|
| Provider Enumeration Date | 09/04/2008 |
| Last Update Date | 03/07/2016 |
| Medicare PECOS PAC ID | 5294709812 |
|---|---|
| Medicare Enrollment ID | O20090319000437 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114175916 | NPI | - | NPPES |
| 110024306G | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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