Provider Demographics
NPI:1760149140
Name:POSITIVE VIBRATIONS LLC
Entity Type:Organization
Organization Name:POSITIVE VIBRATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:G
Authorized Official - Last Name:TELEMAQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:475-243-8879
Mailing Address - Street 1:6 COUNTRY WALK
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-5326
Mailing Address - Country:US
Mailing Address - Phone:475-243-8879
Mailing Address - Fax:
Practice Address - Street 1:6 COUNTRY WALK
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-5326
Practice Address - Country:US
Practice Address - Phone:475-269-2106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-20
Last Update Date:2021-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health