Provider Demographics
NPI:1316133325
Name:CHELSEA JEWISH COMMUNITY, INC.
Entity type:Organization
Organization Name:CHELSEA JEWISH COMMUNITY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-887-0001
Mailing Address - Street 1:165 CAPTAINS ROW
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-4019
Mailing Address - Country:US
Mailing Address - Phone:617-887-0001
Mailing Address - Fax:617-889-6176
Practice Address - Street 1:123 CAPTAINS ROW
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-4019
Practice Address - Country:US
Practice Address - Phone:617-889-0779
Practice Address - Fax:617-889-1779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7RKJ251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA221584Medicare Oscar/Certification