1699180786 NPI number — CAREWELL THERAPY PLUS

Table of content: (NPI 1699180786)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699180786 NPI number — CAREWELL THERAPY PLUS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAREWELL THERAPY PLUS
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:
1699180786
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
141 LONGWATER DR
Provider Second Line Business Mailing Address:
SUITE 104
Provider Business Mailing Address City Name:
NORWELL
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02061-1632
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
339-788-9635
Provider Business Mailing Address Fax Number:
339-788-9534

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
141 LONGWATER DR
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
NORWELL
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02061-1632
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
339-788-9635
Provider Business Practice Location Address Fax Number:
339-788-9534
Provider Enumeration Date:
06/26/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MORGANELLI
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
F
Authorized Official Title or Position:
EXECUTIVE DIRECTOR/OWNER
Authorized Official Telephone Number:
339-788-9635

Provider Taxonomy Codes

  • Taxonomy code: 311ZA0620X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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