Healthcare Provider Details

I. General information

NPI: 1801655345
Provider Name (Legal Business Name): ABLE CARE HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 HYDE PARK AVE
HYDE PARK MA
02136-2713
US

IV. Provider business mailing address

1351 HYDE PARK AVE
HYDE PARK MA
02136-2713
US

V. Phone/Fax

Practice location:
  • Phone: 617-360-7960
  • Fax: 617-360-7961
Mailing address:
  • Phone: 617-360-7960
  • Fax: 617-360-7961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MUTHSOUS MARCEL
Title or Position: PRESIDENT
Credential: NURSE PRACTITIONER
Phone: 781-354-2968