Provider Demographics
NPI:1891038089
Name:HEALTHIER YOU WELLNESS NUTRITION PARTNERS OF GREATER BOSTON, LLC
Entity Type:Organization
Organization Name:HEALTHIER YOU WELLNESS NUTRITION PARTNERS OF GREATER BOSTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARNITE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-663-6447
Mailing Address - Street 1:797 N MAIN ST
Mailing Address - Street 2:6
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-2446
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:797 N MAIN ST
Practice Address - Street 2:6
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2446
Practice Address - Country:US
Practice Address - Phone:508-663-6447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-05
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization