Provider Demographics
NPI:1720647209
Name:FAMILY HEALTH CENTER OF WORCESTER, INC.
Entity Type:Organization
Organization Name:FAMILY HEALTH CENTER OF WORCESTER, INC.
Other - Org Name:WORCESTER HEALTH CARE FOR THE HOMELESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER OF PROVIDER RELATIONS/CRED.
Authorized Official - Prefix:
Authorized Official - First Name:ALYDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JUSTINIANO-FRANZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-860-7962
Mailing Address - Street 1:26 QUEEN STREET
Mailing Address - Street 2:CREDENTIALING DEPT
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01610-2473
Mailing Address - Country:US
Mailing Address - Phone:508-860-7962
Mailing Address - Fax:508-796-7014
Practice Address - Street 1:199 CHANDLER ST FL 4
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-3088
Practice Address - Country:US
Practice Address - Phone:508-860-7888
Practice Address - Fax:508-796-7053
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY HEALTH CENTER OF WORCESTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-10
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)