Healthcare Provider Details

I. General information

NPI: 1992127880
Provider Name (Legal Business Name): KERNWOOD ADULT DAY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2014
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 KERNWOOD DR
LYNN MA
01904-1711
US

IV. Provider business mailing address

51 SUMMER ST
ROWLEY MA
01969-1835
US

V. Phone/Fax

Practice location:
  • Phone: 978-948-7383
  • Fax: 978-948-3421
Mailing address:
  • Phone: 978-948-7383
  • Fax: 978-948-3421

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: SHERRILL ERIN O'GORMAN
Title or Position: CORP. DIRECTOR OF ADMINISTRATION
Credential:
Phone: 978-948-7383