Provider Demographics
NPI:1508373598
Name:AT EASE MENTAL HEALTH INC
Entity Type:Organization
Organization Name:AT EASE MENTAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:D
Authorized Official - Last Name:BELLISTRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-875-9646
Mailing Address - Street 1:30 CONWELL ST UNIT 12
Mailing Address - Street 2:
Mailing Address - City:PROVINCETOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02657-1548
Mailing Address - Country:US
Mailing Address - Phone:617-875-9646
Mailing Address - Fax:866-437-5208
Practice Address - Street 1:30 CONWELL ST UNIT 12
Practice Address - Street 2:
Practice Address - City:PROVINCETOWN
Practice Address - State:MA
Practice Address - Zip Code:02657-1548
Practice Address - Country:US
Practice Address - Phone:617-875-9646
Practice Address - Fax:866-437-5208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN196377163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, AdultGroup - Single Specialty