| Woosource Llc | |
|
68 Harrison Ave Ste 605 Boston MA 02111-1929 | |
| (508) 969-3818 | |
| Not Available |
| Full Name | Woosource Llc |
|---|---|
| Speciality | Social Worker |
| Location | 68 Harrison Ave Ste 605, Boston, Massachusetts |
| Authorized Official Name and Position | Enmanuel Feliz (OWNER) |
| Authorized Official Contact | 8177360400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woosource Llc 68 Harrison Ave Ste 605 Boston MA 02111-1929 Ph: (817) 736-0400 | Woosource Llc 68 Harrison Ave Ste 605 Boston MA 02111-1929 Ph: (508) 969-3818 |
| NPI Number | 1306697784 |
|---|---|
| Provider Enumeration Date | 04/01/2024 |
| Last Update Date | 04/01/2024 |
| Certification Date | 04/01/2024 |
| Medicare PECOS PAC ID | 5890136352 |
|---|---|
| Medicare Enrollment ID | O20240515000724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306697784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Enmanuel Feliz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902490170 PECOS PAC ID: 2163897711 Enrollment ID: I20230412001864 |
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