Provider Demographics
NPI:1346486529
Name:PRIORITY PROFESSIONAL CARE, LLC
Entity Type:Organization
Organization Name:PRIORITY PROFESSIONAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:CANTON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:617-368-0820
Mailing Address - Street 1:51 NEPONSET AVE
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122-3321
Mailing Address - Country:US
Mailing Address - Phone:617-368-0820
Mailing Address - Fax:857-598-4816
Practice Address - Street 1:51 NEPONSET AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02122-3321
Practice Address - Country:US
Practice Address - Phone:617-368-0820
Practice Address - Fax:857-598-4816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4WMC261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center