Provider Demographics
NPI:1063086494
Name:MARRAKECH, INC
Entity type:Organization
Organization Name:MARRAKECH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF BUSINESS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-389-2970
Mailing Address - Street 1:6 LUNAR DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-2322
Mailing Address - Country:US
Mailing Address - Phone:203-389-2970
Mailing Address - Fax:203-397-0658
Practice Address - Street 1:450 ISLAND LN
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-7506
Practice Address - Country:US
Practice Address - Phone:203-389-2970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty