Healthcare Provider Details

I. General information

NPI: 1164824157
Provider Name (Legal Business Name): LYNN COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2014
Last Update Date: 09/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 UNION ST
LYNN MA
01901-1314
US

IV. Provider business mailing address

269 UNION ST
LYNN MA
01901-1314
US

V. Phone/Fax

Practice location:
  • Phone: 781-596-2502
  • Fax: 781-596-3966
Mailing address:
  • Phone: 781-596-2502
  • Fax: 781-596-3966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number4735
License Number StateMA

VIII. Authorized Official

Name: MS. MS. LORI ABRAMS BERR
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW/MPH
Phone: 781-596-2502