=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942444591
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTH SHORE HOME CARE RESOURCES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/27/2009
-----------------------------------------------------
Last Update Date | 04/27/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 170 UNION ST SUITE 302
-----------------------------------------------------
City | LYNN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01901-1335
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-595-2863
-----------------------------------------------------
Fax | 781-592-7839
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 170 UNION ST SUITE 302
-----------------------------------------------------
City | LYNN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01901-1335
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 781-595-2863
-----------------------------------------------------
Fax | 781-592-7839
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER MANAGER
-----------------------------------------------------
Name | STEPHEN M MCGUIRK
-----------------------------------------------------
Credential | ESQ
-----------------------------------------------------
Telephone | 781-595-2863
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------