Healthcare Provider Details

I. General information

NPI: 1558221390
Provider Name (Legal Business Name): HOUSE OF HEARTS MASSACHUSETTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2025
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

859 WILLARD ST STE 400
QUINCY MA
02169-7469
US

IV. Provider business mailing address

4974 SARAZEN DR
HOLLYWOOD FL
33021-2266
US

V. Phone/Fax

Practice location:
  • Phone: 347-906-1234
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: NOAH GOLDSTEIN
Title or Position: CEO
Credential:
Phone: 305-209-3144