Provider Demographics
NPI:1013440841
Name:MOVING AHEAD LLC
Entity Type:Organization
Organization Name:MOVING AHEAD LLC
Other - Org Name:LIFEDESIGNS REABILITY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THATCHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNI
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:203-924-7866
Mailing Address - Street 1:18 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-3104
Mailing Address - Country:US
Mailing Address - Phone:203-924-7866
Mailing Address - Fax:
Practice Address - Street 1:18 CENTER ST
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-3104
Practice Address - Country:US
Practice Address - Phone:203-924-7866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-08
Last Update Date:2017-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty