Executive Recovery Coach, Inc

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

156015 Issued in MA

Legal business name

EXECUTIVE RECOVERY COACH, INC

Doing business as

Executive Home Detox

Practice address

239 West St
Reading, MA 01867-2848

Phone

(781) 439-2603

NPI assigned

Aug 29, 2013

Organization subpart

Yes

Parent organization

EXECUTIVE RECOVERY COACH, INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. William Paul Carrick, RN

Title

President

Phone

(781) 439-2603

Specialties & licenses 2

Addresses

Other names 1

• Executive Home Detox Doing business as

Part of

Executive Recovery Coach Inc

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377734400000",
    "number": "1407280118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 WEST ST",
            "city": "READING",
            "state": "MA",
            "postal_code": "018672848",
            "telephone_number": "781-439-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 WEST ST",
            "city": "READING",
            "state": "MA",
            "postal_code": "018672848",
            "telephone_number": "781-439-2603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE RECOVERY COACH, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXECUTIVE RECOVERY COACH, INC",
        "enumeration_date": "2013-08-29",
        "last_updated": "2013-08-29",
        "status": "A",
        "authorized_official_last_name": "CARRICK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-439-2603",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "MA",
            "license": "156015",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NY",
            "license": "22583743",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Executive Home Detox",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nursing Care Agency in Reading, MA
• Providers in Reading, MA by specialty
• Nursing Care Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.