Active NPI
Center for Community Health, Education & Research, Inc
- Community/Behavioral Health Agency
- Mattapan, MA
National Provider Identifier
1306997473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 4EDY
- Legal business name
- CENTER FOR COMMUNITY HEALTH, EDUCATION & RESEARCH, INC
- Practice address
- 745 River St
Mattapan, MA 02126-1941 - Phone
- (617) 364-3035
- Fax
- (617) 364-3059
- NPI assigned
- Jan 16, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Eustache Jean-Louis, M.D. MPH
- Title
- Executive Director
- Phone
- (617) 265-0628
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 4EDY | MA | Primary |
Addresses
Primary practice location
745 River St
Mattapan, MA 02126-1941
Mailing address
420 Washington St
Dorchester Center, MA 02124-1127
Phone (617) 265-0628
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1321943 | Medicaid | MA |
National Provider Directory
National Provider DirectoryLocations
420 Washington St
Dorchester Center, MA 02124
Phone (617) 265-0628
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Dorchester Center, MA
- NPI 1932289410
-
- Mental Health Counselor
- Dorchester Center, MA
- NPI 1144360637
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1306997473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 WASHINGTON ST",
"city": "DORCHESTER CENTER",
"state": "MA",
"postal_code": "021241127",
"telephone_number": "617-265-0628",
"fax_number": "617-265-4134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "745 RIVER ST",
"city": "MATTAPAN",
"state": "MA",
"postal_code": "021261941",
"telephone_number": "617-364-3035",
"fax_number": "617-364-3059"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CENTER FOR COMMUNITY HEALTH, EDUCATION & RESEARCH, INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-16",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "JEAN-LOUIS",
"authorized_official_first_name": "EUSTACHE",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "617-265-0628",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D. MPH"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "MA",
"license": "4EDY",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1321943",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mattapan, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.