Healthcare Provider Details

I. General information

NPI: 1255638318
Provider Name (Legal Business Name): TAIGHSOLAIS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2011
Last Update Date: 02/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 CORDAGE PARK CIR STE 123
PLYMOUTH MA
02360-7320
US

IV. Provider business mailing address

36 CORDAGE PARK CIR STE 123
PLYMOUTH MA
02360-7320
US

V. Phone/Fax

Practice location:
  • Phone: 508-927-6920
  • Fax: 508-689-7695
Mailing address:
  • Phone: 508-927-6920
  • Fax: 508-689-7695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateMA

VIII. Authorized Official

Name: ELIZABETH HAUGHN
Title or Position: OFFICE MANAGER
Credential:
Phone: 508-927-6920