Provider Demographics
NPI:1679594345
Name:FRANCISCAN HOSPITAL FOR CHILDREN INC
Entity Type:Organization
Organization Name:FRANCISCAN HOSPITAL FOR CHILDREN INC
Other - Org Name:FRANCISCAN CHILDRENS HOSPITAL AND REHABILITATION CENTER INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:T
Authorized Official - Last Name:MCLOON
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:617-779-1111
Mailing Address - Street 1:30 WARREN STREET
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:617-779-1111
Mailing Address - Fax:617-779-1109
Practice Address - Street 1:30 WARREN STREET
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:617-779-1229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2008-07-29
Deactivation Date:2008-06-03
Deactivation Code:
Reactivation Date:2008-07-29
Provider Licenses
StateLicense IDTaxonomies
MA110251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA22-7439Medicare ID - Type UnspecifiedHOME HEALTH