Provider Demographics
NPI:1407097207
Name:PROFESSIONAL PROFILES, INC.
Entity Type:Organization
Organization Name:PROFESSIONAL PROFILES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KITTREDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-774-0022
Mailing Address - Street 1:85 CONSTITUTION LN
Mailing Address - Street 2:SUITE #100D
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3694
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:85 CONSTITUTION LN
Practice Address - Street 2:SUITE #100D
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3694
Practice Address - Country:US
Practice Address - Phone:978-774-0022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care