Provider Demographics
NPI:1114363314
Name:HOSPITALITY RESORTS
Entity Type:Organization
Organization Name:HOSPITALITY RESORTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:TOOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-771-6621
Mailing Address - Street 1:71 PINE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-2122
Mailing Address - Country:US
Mailing Address - Phone:978-771-6621
Mailing Address - Fax:
Practice Address - Street 1:71 PINE RIDGE RD
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-2122
Practice Address - Country:US
Practice Address - Phone:978-771-6621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service