| Organization Name: | BRAINCARE, LLC |
| NPI Number: | 1538513106 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JANICE SHOCK (SR DIRECTOR OF OPERATIONS) |
| Mailing Address: | 101 Federal St Ste 1900 Boston |
| State: | MA US |
| Postal Code: | 021101817 |
| Phone Number: | 8668482522 |
| Fax Number: | 8772901544 |
| NPI Enumeration Date: | 04/20/2016 |
| NPI Last Update Date: | 04/20/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 293D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Laboratories |
| Taxonomy Classification: | Physiological Laboratory |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A laboratory that operates independently of a hospital and physician |