1043235534 NPI number — CORPORATE EAP RESOURCES, INC.

Table of content: (NPI 1043235534)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043235534 NPI number — CORPORATE EAP RESOURCES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORPORATE EAP RESOURCES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043235534
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
47 LIBERTY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ACTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01720-3547
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
866-635-1712
Provider Business Mailing Address Fax Number:
978-635-1712

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
184 GREAT RD
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
ACTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01720-5758
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-635-1712
Provider Business Practice Location Address Fax Number:
978-635-1712
Provider Enumeration Date:
07/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LALIBERTE
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
JUSTIN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
866-635-1712

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  100058 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 008355 . This is a "HARVARD PILGRIM HEALTHCAR" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 64266851 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: PO1415 . This is a "BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 464808 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2135799 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 138856 . This is a "ANTHEM BCBS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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