1912181843 NPI number — HEALTHY HEART SLEEP PROGRAMS, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912181843 NPI number — HEALTHY HEART SLEEP PROGRAMS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTHY HEART SLEEP PROGRAMS, 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:
1912181843
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
210 QUINCY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROCKTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02302-2862
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-784-5530
Provider Business Mailing Address Fax Number:
781-634-0457

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
541 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 314
Provider Business Practice Location Address City Name:
SOUTH WEYMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02190
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-952-1460
Provider Business Practice Location Address Fax Number:
781-952-1465
Provider Enumeration Date:
12/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BOHAN
Authorized Official First Name:
PATRICK
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT & CEO
Authorized Official Telephone Number:
781-799-3120

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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