Healthcare Provider Details

I. General information

NPI: 1184600660
Provider Name (Legal Business Name): ELEMENT CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 06/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 FRIEND ST
LYNN MA
01902-3068
US

IV. Provider business mailing address

37 FRIEND ST
LYNN MA
01902-3068
US

V. Phone/Fax

Practice location:
  • Phone: 781-715-6620
  • Fax: 781-715-6699
Mailing address:
  • Phone: 781-715-6620
  • Fax: 781-715-6699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number1902601
License Number StateMA

VIII. Authorized Official

Name: MR. ROBERT P DURANTE
Title or Position: CFO
Credential:
Phone: 781-715-6620