Healthcare Provider Details

I. General information

NPI: 1285348268
Provider Name (Legal Business Name): OUR HOPEFUL AND HOLISTIC HEALING CENTER, PLLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2023
Last Update Date: 09/30/2023
Certification Date: 09/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 MAIN ST STE 200
CHARLESTOWN MA
02129-1119
US

IV. Provider business mailing address

529 MAIN ST STE 200
CHARLESTOWN MA
02129-1119
US

V. Phone/Fax

Practice location:
  • Phone: 617-398-7119
  • Fax: 617-871-6834
Mailing address:
  • Phone: 617-398-7119
  • Fax: 617-871-6834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHARLENE JULIEN
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 617-398-7119