1609176296 NPI number — CABSLP, INC

Table of content: (NPI 1609176296)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609176296 NPI number — CABSLP, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CABSLP, 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:
1609176296
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/28/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
109 BEACON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01301-2603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-773-5008
Provider Business Mailing Address Fax Number:
413-586-1946

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 ROUNDHOUSE PLZ STE 202203
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
NORTHAMPTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01060-4401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-586-1945
Provider Business Practice Location Address Fax Number:
413-586-1946
Provider Enumeration Date:
10/28/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BERNIER
Authorized Official First Name:
CARLA
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
413-773-5008

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  2099 , 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: 1427082205 . This is a "NPI" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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