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LYNN SHORE REST HOME INC NPI 1396902235


NPI Information

NPI: 1396902235
Provider Name: LYNN SHORE REST HOME, INC
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

CLIA Number: 22D2167817

Address:
37 BREED ST
LYNN, MA
ZIP 01902
Phone: (781) 595-7110
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LYNN SHORE REST HOME, INC is an adult care home custodial care facility in Lynn, MA. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. LYNN SHORE REST HOME, INC NPI is 1396902235. The provider is registered as an organization entity type.

The provider's business location address is:

37 BREED ST
LYNN, MA
ZIP 01902-101
Phone: (781) 595-7110
Fax: (781) 592-2846

The provider's authorized official is Susan Mary Solimine .
The authorized official title is Administrator and has the following contact phone number (781) 595-7110.

The CLIA number assigned to this NPI record is 22D2167817 - other - rest home with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/19/2008 and was last updated on 5/19/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311ZA0620XCustodial Care FacilityAdult Care Home1287MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15505020MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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