1447618483 NPI number — TIMELESS TRANSITIONS OF OHIO LLC

Table of content: MARIE DARLENE LAWSON CNM (NPI 1740379882)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447618483 NPI number — TIMELESS TRANSITIONS OF OHIO LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TIMELESS TRANSITIONS OF OHIO LLC
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:
1447618483
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
184 W 8TH ST
Provider Second Line Business Mailing Address:
1
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02127-3040
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
184 W 8TH ST
Provider Second Line Business Practice Location Address:
1
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02127-3040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-275-8188
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/05/2016

Additional Information

Authorized Official

Authorized Official Last Name:
ELERICK
Authorized Official First Name:
JENNA
Authorized Official Middle Name:
ROSE
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
857-275-8188

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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