Healthcare Provider Details

I. General information

NPI: 1386314243
Provider Name (Legal Business Name): HUNTERSEVEN FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2021
Last Update Date: 01/13/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 CEDAR RD
NORTH ATTLEBORO MA
02763-1107
US

IV. Provider business mailing address

306 THAYER ST UNIT 2694
PROVIDENCE RI
02906-7716
US

V. Phone/Fax

Practice location:
  • Phone: 401-965-7097
  • Fax:
Mailing address:
  • Phone: 202-599-6477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP0904X
TaxonomyFederal Public Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code364SC1501X
TaxonomyCommunity Health/Public Health Clinical Nurse Specialist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHELSEY SIMONI
Title or Position: CLINICAL NURSE RESEARCHER / NCM
Credential:
Phone: 401-965-7097