Provider Demographics
NPI:1770272460
Name:TWIST OF PASSION
Entity type:Organization
Organization Name:TWIST OF PASSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:0WNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:SPECIALIST
Authorized Official - Phone:617-922-8338
Mailing Address - Street 1:16 MATTAKEESET ST APT 2
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:MA
Mailing Address - Zip Code:02136-6710
Mailing Address - Country:US
Mailing Address - Phone:617-922-8338
Mailing Address - Fax:
Practice Address - Street 1:57 HAZELTON ST
Practice Address - Street 2:
Practice Address - City:MATTAPAN
Practice Address - State:MA
Practice Address - Zip Code:02126-3105
Practice Address - Country:US
Practice Address - Phone:617-922-8338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies