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General NPI Number Information
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NPI Number | 1144041674
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Entity Type | Organization
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Legal Business Name | MAYOLA HOME CARE SERVICE OF NORTH SHORE, LLC
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 20 LYNNFIELD ST
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City | LYNN
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State | MA
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Zip | 01904-2222
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Country | US
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Telephone | 781-299-3667
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Fax |
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Provider Business Mailing Address
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Address Line | 68 HARRISON AVE STE 605
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City | BOSTON
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State | MA
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Zip | 02111-1929
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Country | US
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Telephone | 978-347-2466
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. YOUM MAYOLA
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Credential |
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Telephone | 781-299-3667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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