Provider Demographics
NPI:1942778923
Name:SAYFTEE
Entity type:Organization
Organization Name:SAYFTEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NIC
Authorized Official - Middle Name:
Authorized Official - Last Name:WILDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-203-7082
Mailing Address - Street 1:12 SEWALL AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5102
Mailing Address - Country:US
Mailing Address - Phone:617-333-8742
Mailing Address - Fax:857-800-8263
Practice Address - Street 1:12 SEWALL AVE
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5102
Practice Address - Country:US
Practice Address - Phone:617-333-8742
Practice Address - Fax:857-800-8263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-07
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0801X
MA7118261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)