JUAN GRULLON (NPI# 1104320357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104320357 |
| Entity Type | Individual |
| Full Name | JUAN GRULLON |
| Practice Address |
302 Eustis St Roxbury MA 02119-3800 |
| Practice Telephone | 6174451123 |
| Mailing Telephone | 6174451123 |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2018-03-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
302 EUSTIS ST |
| City | ROXBURY |
| State | MA |
| Zip Code | 02119-3800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518461482 | Ariany Sanchez | Case Manager/Care Coordinator | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-23 |
| 1396249280 | Michelle Santiago | Case Manager/Care Coordinator | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-23 |
| 1184128050 | Anna M Rodriguez | Counselor | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-23 |
| 1700380672 | Frances Samidy-ortiz | Case Manager/Care Coordinator | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-23 |
| 1104320365 | Mary-alyssa E Nieman | Counselor | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-22 |
| 1922502186 | Dina Park-matsas | Counselor | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-22 |
| 1902300163 | Felix Rivera | Counselor | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-22 |
| 1407350655 | Beanette Damiron | Counselor | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-22 |
| 1477057636 | Dibel Prieto | Case Manager/Care Coordinator | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427661644 | Christina Kim Hunt | Case Manager/Care Coordinator | 75 Amory St, Garden Level, Boston, MA 02119 | 2020-08-27 |
| 1962021089 | Taha Fathima Khan | Student in an Organized Health Care Education/Training Program | Boston Medical Center, 801 Albany Street, 3rd Floor, Department of Pediatrics, Boston, MA 02119 | 2020-04-09 |
| 1154957132 | Katherine Erin Douglas | Pediatrics | 801 Albany Street, 3rd Floor, Department of Pediatrics, Boston, MA 02119 | 2020-03-21 |
| 1720536568 | Ramy Y Barrett | Counselor | 77 Savin Street, Apartment # 3, Boston, MA 02119 | 2016-09-21 |
| 1083089676 | Natasha Cruz | Counselor | 263 Eustis Street, Roxbury, MA 02119 | 2015-12-08 |
| 1922478486 | Natalie Jones | Counselor | 520 Dudley St., Roxbury, MA 02119 | 2015-09-28 |
| 1922484799 | Dina Ghaly-habib | Student in an Organized Health Care Education/Training Program | 100 East Newton St., G-706, Boston, MA 02119 | 2015-08-04 |
| 1942697248 | Pyramid Builders | Case Management | 11 Roxbury Street, Boston, MA 02119 | 2015-04-24 |
| 1063810984 | Sophia Smalls | Counselor | 250 Walnut Ave, Apt. 10, Boston, MA 02119 | 2014-12-09 |
| 1750705059 | Alasa Hawkins | Counselor | 502 Dudley St, Roxbury, MA 02119 | 2014-02-07 |
| Find all providers in zip 02119 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083089676 | Natasha Cruz | Counselor | 263 Eustis Street, Roxbury, MA 02119 | 2015-12-08 |
| 1083046205 | Christopher Conway | Counselor | 432 Dudley St Ste 211, Roxbury, MA 02119-2763 | 2013-07-30 |
| 1215297304 | Earl Dandy Jr. | Counselor | 15 Elmore St # 2, Roxbury, MA 02119-1618 | 2012-05-22 |
| 1437385754 | Alice Wood Griffin | Counselor | 28 Hemlock Rd, Roxbury, CT 06783-1409 | 2009-06-01 |
| 1861612053 | Ameatriss Little | Counselor | 55 Topeka Street, Roxbury, MA 02215 | 2007-04-27 |
| 1184128050 | Anna M Rodriguez | Counselor | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-23 |
| 1104320365 | Mary-alyssa E Nieman | Counselor | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-22 |
| 1881198034 | Jose O Colon | Counselor | 245 Eustis St, Roxbury, MA 02119-2826 | 2018-03-22 |
| 1922502186 | Dina Park-matsas | Counselor | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-22 |
| 1902300163 | Felix Rivera | Counselor | 302 Eustis St, Roxbury, MA 02119-3800 | 2018-03-22 |
| Find all providers in ROXBURY | ||||
Please comment or provide details below to improve the information on JUAN GRULLON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.