Provider Demographics
NPI:1508214974
Name:SHORELINE HEALTHCARE CENTER OF LOWELL LLC
Entity Type:Organization
Organization Name:SHORELINE HEALTHCARE CENTER OF LOWELL LLC
Other - Org Name:TOWN AND COUNTRY HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-741-7199
Mailing Address - Street 1:259 BALDWIN ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-2211
Mailing Address - Country:US
Mailing Address - Phone:978-454-5438
Mailing Address - Fax:
Practice Address - Street 1:259 BALDWIN ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-2211
Practice Address - Country:US
Practice Address - Phone:978-454-5438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHORELINE HEALTHCARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility