Organization Active NPI

Center for Community Health, Education & Research, Inc

  • Community/Behavioral Health Agency
  • Mattapan, MA
National Provider Identifier
1306997473
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
4EDY Issued in MA
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1321943MedicaidMA

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.