Basic Information
| Provider Information | |||||||||
| NPI: | 1528505195 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MOTION LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | BOSTON ABILITY CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 49 WALNUT ST | ||||||||
| Address2: | BLDG #3 | ||||||||
| City: | WELLESLEY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024812117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7812390100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 49 WALNUT ST | ||||||||
| Address2: | BLDG #3 | ||||||||
| City: | WELLESLEY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 024812117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7812390100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/20/2017 | ||||||||
| LastUpdateDate: | 01/20/2017 | ||||||||
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| AuthorizedOfficialLastName: | WADE | ||||||||
| AuthorizedOfficialFirstName: | JANET | ||||||||
| AuthorizedOfficialMiddleName: | CREW | ||||||||
| AuthorizedOfficialTitleorPosition: | CLINIC OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7812390100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.