Provider Demographics
NPI:1073964540
Name:CURAHEALTH BOSTON NORTH SHORE, LLC
Entity Type:Organization
Organization Name:CURAHEALTH BOSTON NORTH SHORE, LLC
Other - Org Name:CURAHEALTH BOSTON NORTH SHORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:W
Authorized Official - Last Name:CROUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-707-9606
Mailing Address - Street 1:650 BEEBALM LN
Mailing Address - Street 2:SUITE 220
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-2955
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15 KING ST
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-4379
Practice Address - Country:US
Practice Address - Phone:978-531-2900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital