Provider Demographics
NPI:1720201296
Name:LUTHERAN SOCIAL SERVICES OF NEW ENGLAND
Entity Type:Organization
Organization Name:LUTHERAN SOCIAL SERVICES OF NEW ENGLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOHR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-997-0800
Mailing Address - Street 1:888 WORCESTER ST
Mailing Address - Street 2:SUITE 160
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-3717
Mailing Address - Country:US
Mailing Address - Phone:781-997-0800
Mailing Address - Fax:781-997-0888
Practice Address - Street 1:25 E NILSSON ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-6604
Practice Address - Country:US
Practice Address - Phone:508-588-5334
Practice Address - Fax:508-588-8775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1901931Medicaid