Provider Demographics
NPI:1053450684
Name:FRANCISCAN HOSPITAL FOR CHILDREN
Entity Type:Organization
Organization Name:FRANCISCAN HOSPITAL FOR CHILDREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:DELLAROCCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-254-3800
Mailing Address - Street 1:30 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3602
Mailing Address - Country:US
Mailing Address - Phone:617-254-3800
Mailing Address - Fax:617-779-1109
Practice Address - Street 1:30 WARREN ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3602
Practice Address - Country:US
Practice Address - Phone:617-254-3800
Practice Address - Fax:617-779-1109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1100939Medicaid