Provider Demographics
NPI:1679619100
Name:CARIBBEAN FOUNDATION OF BOSTON
Entity type:Organization
Organization Name:CARIBBEAN FOUNDATION OF BOSTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BEULAH
Authorized Official - Middle Name:
Authorized Official - Last Name:PROVIDENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-445-1228
Mailing Address - Street 1:317 BLUE HILL AVE
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02121-4302
Mailing Address - Country:US
Mailing Address - Phone:617-445-1228
Mailing Address - Fax:617-427-6355
Practice Address - Street 1:317 BLUE HILL AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02121-4302
Practice Address - Country:US
Practice Address - Phone:617-445-1228
Practice Address - Fax:617-427-6355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health