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General NPI Number Information
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NPI Number | 1902352925
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Entity Type | Organization
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Legal Business Name | ECOPOLITAN ECO-HEALTH COMMUNITY
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Dates
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Enumeration Date | 08/30/2016
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Last Update Date | 08/30/2016
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Provider Practice Location Address
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Address Line | 6 BALDWIN RD
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City | DENNIS
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State | MA
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Zip | 02638-2335
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Country | US
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Telephone | 612-326-6888
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Fax |
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Provider Business Mailing Address
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Address Line | 6 BALDWIN RD
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City | DENNIS
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State | MA
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Zip | 02638-2335
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MS. ANGELA DOEL
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Credential | MS
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Telephone | 612-326-6839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number | N159
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License Number State | MN
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