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General NPI Number Information
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NPI Number | 1952307530
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Entity Type | Organization
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Legal Business Name | LOWELL COMMUNITY HEALTH CENTER, INC.
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 161 JACKSON ST
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City | LOWELL
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State | MA
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Zip | 01852-2103
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Country | US
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Telephone | 978-322-8590
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Fax | 978-453-8043
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Provider Business Mailing Address
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Address Line | 161 JACKSON ST
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City | LOWELL
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State | MA
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Zip | 01852-2103
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Country | US
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Telephone | 978-322-8590
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Fax | 978-453-8043
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Authorized Official
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Title or Position | CEO
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Name | SUSAN WEST LEVINE
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Credential |
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Telephone | 978-937-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 4VAC
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | 4VAC
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License Number State | MA
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