Provider Demographics
NPI:1659935732
Name:NOW THAT I CAN FLY LLC
Entity Type:Organization
Organization Name:NOW THAT I CAN FLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BESS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHILD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-439-4610
Mailing Address - Street 1:300 W MAIN ST STE A4
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-2132
Mailing Address - Country:US
Mailing Address - Phone:508-439-4610
Mailing Address - Fax:
Practice Address - Street 1:300 W MAIN ST STE A4
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-2132
Practice Address - Country:US
Practice Address - Phone:508-439-4610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty