Congenial Healthcare, LLC

NPI #1790241735 in Peabody, Massachusetts

Provider Information

NPI Number: 1790241735
Entity Type: Organization
Organization Name: Congenial Healthcare, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: CONGENIAL HEALTHCARE, LLC
Primary Specialty: Internal Medicine
Enumeration Date: Feb 14, 2019
Last Updated: Feb 14, 2019

Practice Location

Address: 1 ROOSEVELT AVE STE 201
City: Peabody
State: Massachusetts
ZIP Code: 01960-2227
Phone: (978) 740-2300

Authorized Official

Name: LISA MARIE ENDERLE
Title: PROVIDER ENROLLMENT
Phone: (978) 712-1681

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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