Provider Demographics
NPI:1124290325
Name:BOSTON PARTNERS IN MENTORING INC
Entity type:Organization
Organization Name:BOSTON PARTNERS IN MENTORING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTING CONTACT
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:L
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MSW/LADCI
Authorized Official - Phone:617-306-6812
Mailing Address - Street 1:PO BOX 181124
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-0012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:54 LAWN ST
Practice Address - Street 2:
Practice Address - City:ROXBURY CROSSING
Practice Address - State:MA
Practice Address - Zip Code:02120-3325
Practice Address - Country:US
Practice Address - Phone:857-383-9941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1096305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1386824746OtherNEIGHBORHOOD HEALTH PLAN