Healthcare Provider Details

I. General information

NPI: 1801095476
Provider Name (Legal Business Name): LYNN ZABOTA ADULT DAY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 08/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 EXCHANGE ST
LYNN MA
01901-1443
US

IV. Provider business mailing address

80 EXCHANGE ST
LYNN MA
01901-1443
US

V. Phone/Fax

Practice location:
  • Phone: 781-595-3200
  • Fax: 781-595-3207
Mailing address:
  • Phone: 781-595-3200
  • Fax: 781-595-3207

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: MR. GENNADIY ITSKIN
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 617-839-8299