Provider Demographics
NPI:1366134199
Name:ONE LIFE AT A TIME LLC
Entity type:Organization
Organization Name:ONE LIFE AT A TIME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DRISCOLL O'NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-797-6104
Mailing Address - Street 1:100 GROSSMAN DR STE 400A
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4949
Mailing Address - Country:US
Mailing Address - Phone:781-681-7003
Mailing Address - Fax:
Practice Address - Street 1:100 GROSSMAN DR STE 400A
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4949
Practice Address - Country:US
Practice Address - Phone:781-681-7003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder