| NPI | 1548589047 |
|---|---|
| Doing Business As | SIDNEY BORUM JR. HEALTH CENTER OF FENWAY HEALTH |
| Entity Type | Organization |
| Authorized Contact | JEFFREY M LIEBERMAN VP Finanace & Administration 617-927-6173 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: MA 4519) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: MA 4519) |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2013-09-11 |