Provider Demographics
NPI:1427179076
Name:SOUTH SHORE ELDER SERVICES INC
Entity Type:Organization
Organization Name:SOUTH SHORE ELDER SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:781-848-3910
Mailing Address - Street 1:159 BAY STATE DR
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-5203
Mailing Address - Country:US
Mailing Address - Phone:781-848-3910
Mailing Address - Fax:781-843-8279
Practice Address - Street 1:159 BAY STATE DR
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-5203
Practice Address - Country:US
Practice Address - Phone:781-848-3910
Practice Address - Fax:781-843-8279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0603937Medicaid