Providence Living LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

PROVIDENCE LIVING LLC

Practice address

896 Beacon St Ste a
Boston, MA 02215-3033

Phone

(617) 314-7544

Fax

(888) 373-9844

NPI assigned

Sep 2, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Dung Gabe Lau, PHD

Title

Coo

Phone

(617) 314-7544

Specialties & licenses 2

Addresses

Other names 1

• Providence Treatment Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Providence Living LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Providence Living LLC

  • Substance Abuse Rehabilitation Facility
  • Honolulu, HI
  • NPI 1003413097
  NPD tax ID
• Providence Living LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Media, PA
  • NPI 1730562711
  NPD tax ID
• Providence Living LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Philadelphia, PA
  • NPI 1962965145
  NPD tax ID

Locations

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1942920459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "896 BEACON ST STE A",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153033",
            "telephone_number": "617-314-7544",
            "fax_number": "888-373-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "896 BEACON ST STE A",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153033",
            "telephone_number": "617-314-7544",
            "fax_number": "888-373-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-02",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "LAU",
        "authorized_official_first_name": "DUNG",
        "authorized_official_middle_name": "GABE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "617-314-7544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Treatment",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Providence Treatment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Francesca Proulx, MD
• Laura Ashley Prout
• Marissa Provencher
• Audrey M Provenzano, MD
• Catarina Grace Provenzano
• Adam Provost, OD
• Christiana Kathleen Prucnal
• Nicole Prudent, MD
• Prudential Dental Associates Inc.
• John V. Pruitt III, M.D.

• Substance Abuse Rehabilitation Facility in Boston, MA
• Providers in Boston, MA by specialty
• Substance Abuse Rehabilitation Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.