Healthcare Provider Details

I. General information

NPI: 1144470089
Provider Name (Legal Business Name): NORTH SHORE ADULT DAY HEALTH CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 09/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 N COMMONS ST
LYNN MA
01905
US

IV. Provider business mailing address

191 N COMMON ST
LYNN MA
01905-2547
US

V. Phone/Fax

Practice location:
  • Phone: 781-595-4888
  • Fax: 781-595-7100
Mailing address:
  • Phone: 781-595-4888
  • Fax: 781-595-7100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. PEARL MORGOVSKY
Title or Position: PARTNER
Credential:
Phone: 617-584-4524