Provider Demographics
NPI:1679211833
Name:PIVOTCARE, LLC
Entity Type:Organization
Organization Name:PIVOTCARE, LLC
Other - Org Name:PIVOTCARE PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MAURA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:781-589-8929
Mailing Address - Street 1:42 TREMONT ST STE 10B
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-5313
Mailing Address - Country:US
Mailing Address - Phone:781-589-8929
Mailing Address - Fax:888-297-6967
Practice Address - Street 1:42 TREMONT ST STE 10B
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-5313
Practice Address - Country:US
Practice Address - Phone:781-589-8929
Practice Address - Fax:888-297-6967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty