Provider Demographics
NPI:1427206614
Name:LOWELL HOUSE INC
Entity Type:Organization
Organization Name:LOWELL HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONOLE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:978-459-8656
Mailing Address - Street 1:555 MERRIMACK ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-3906
Mailing Address - Country:US
Mailing Address - Phone:978-459-8656
Mailing Address - Fax:978-937-2559
Practice Address - Street 1:555 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-3906
Practice Address - Country:US
Practice Address - Phone:978-459-8656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder