Healthcare Provider Details

I. General information

NPI: 1225456510
Provider Name (Legal Business Name): POSITIVE SYNERGY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1573 FALL RIVER AVE
SEEKONK MA
02771-3740
US

IV. Provider business mailing address

1573 FALL RIVER AVE
SEEKONK MA
02771-3740
US

V. Phone/Fax

Practice location:
  • Phone: 508-617-8396
  • Fax: 508-401-2696
Mailing address:
  • Phone: 508-343-0630
  • Fax: 508-401-2696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MARGOT PAGE
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 508-343-0630