Provider Demographics
NPI:1073096624
Name:UNITAS HEALTHCARE SYSTEMS, LLC
Entity Type:Organization
Organization Name:UNITAS HEALTHCARE SYSTEMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROOSEVELT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:III
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:617-401-7441
Mailing Address - Street 1:1208 VFW PKWY STE 301
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02132-4344
Mailing Address - Country:US
Mailing Address - Phone:617-401-7441
Mailing Address - Fax:617-203-6651
Practice Address - Street 1:1208 VFW PKWY STE 301
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02132-4344
Practice Address - Country:US
Practice Address - Phone:617-401-7441
Practice Address - Fax:617-203-6651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty