Provider Demographics
NPI:1306499181
Name:SHINDIGZ PARTIES LLC
Entity type:Organization
Organization Name:SHINDIGZ PARTIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MACKINNON
Authorized Official - Suffix:
Authorized Official - Credentials:BEHAVIOR ANALYST
Authorized Official - Phone:508-847-5730
Mailing Address - Street 1:77 CALYPSO LN
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-3601
Mailing Address - Country:US
Mailing Address - Phone:781-837-2072
Mailing Address - Fax:
Practice Address - Street 1:31 SCHOOSETT ST UNIT 201
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1877
Practice Address - Country:US
Practice Address - Phone:508-847-5730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHINDIGZ PARTIES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-20
Last Update Date:2019-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty