Healthcare Provider Details

I. General information

NPI: 1568258499
Provider Name (Legal Business Name): THE HEALTH CO-LAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 CHASE HILL RD
ALBANY NH
03818-7208
US

IV. Provider business mailing address

21 HARRISON ST APT 2
SOMERVILLE MA
02143-3618
US

V. Phone/Fax

Practice location:
  • Phone: 517-243-9620
  • Fax:
Mailing address:
  • Phone: 517-243-9620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State

VIII. Authorized Official

Name: AARON HOLMAN
Title or Position: PARTNER
Credential:
Phone: 517-243-9620