Provider Demographics
NPI:1205841038
Name:CHESTNUT HILL BENEVOLENT ASSOCIATION
Entity Type:Organization
Organization Name:CHESTNUT HILL BENEVOLENT ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANIVA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-734-5600
Mailing Address - Street 1:910 BOYLSTON ST
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-2404
Mailing Address - Country:US
Mailing Address - Phone:617-734-5600
Mailing Address - Fax:617-734-7840
Practice Address - Street 1:910 BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-2404
Practice Address - Country:US
Practice Address - Phone:617-734-5600
Practice Address - Fax:617-734-7840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282J00000XHospitalsReligious Nonmedical Health Care Institution
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA221990Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER