| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 38 Broad St, Quincy, Massachusetts |
| Authorized Official Name and Position | Agnes W Leung (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8576541200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
780 Albany St Boston MA 02118-2755 Ph: (857) 654-1227 | 38 Broad St Quincy MA 02169 Ph: (617) 770-3314 |
| NPI Number | 1336382944 |
|---|---|
| Provider Enumeration Date | 04/13/2009 |
| Last Update Date | 05/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336382944 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 4LQX (Massachusetts) | Primary |
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