Provider Demographics
NPI:1114742749
Name:ONE CLEARVIEW HEALTH LLC
Entity type:Organization
Organization Name:ONE CLEARVIEW HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NOUGYE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUTUNGI-MUKOMA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC, PMHNP-BC
Authorized Official - Phone:781-921-3781
Mailing Address - Street 1:578 MAIN ST STE 4B
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-4094
Mailing Address - Country:US
Mailing Address - Phone:781-921-3781
Mailing Address - Fax:781-394-8920
Practice Address - Street 1:578 MAIN ST STE 4B
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-4094
Practice Address - Country:US
Practice Address - Phone:857-294-7441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-19
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health