Basic Information
| Provider Information | |||||||||
| NPI: | 1174542013 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FRANCISCAN HOSPITAL FOR CHILDREN, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 WARREN ST | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021353602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6172543800 | ||||||||
| FaxNumber: | 6177791119 | ||||||||
| Practice Location | |||||||||
| Address1: | 30 WARREN ST | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021353602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6172543800 | ||||||||
| FaxNumber: | 6177791119 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2006 | ||||||||
| LastUpdateDate: | 01/11/2022 | ||||||||
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| AuthorizedOfficialLastName: | CROSBY | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 6172543800 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QD0000X | 2221 | MA | N | Ambulatory Health Care Facilities | Clinic/Center | Dental | 261QS0112X | N | Ambulatory Health Care Facilities | Clinic/Center | Oral and Maxillofacial Surgery | 283XC2000X | 110 | MA | Y | Hospitals | Rehabilitation Hospital | Children |
ID Information
| ID | Type | State | Issuer | Description | 1100939 | 05 | MA | MEDICAID | 1200925 | 05 | MA | MEDICAID |