Provider Demographics
NPI:1811290919
Name:HEALTHY BEGINNINGS CENTER FOR WOMEN, LLC
Entity type:Organization
Organization Name:HEALTHY BEGINNINGS CENTER FOR WOMEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ECONOMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-732-5600
Mailing Address - Street 1:215 TOLL GATE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4458
Mailing Address - Country:US
Mailing Address - Phone:401-732-5600
Mailing Address - Fax:401-734-9400
Practice Address - Street 1:215 TOLL GATE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4458
Practice Address - Country:US
Practice Address - Phone:401-732-5600
Practice Address - Fax:401-734-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-10
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD09195207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIHE84763Medicaid
RI0021003Medicare PIN