Provider Demographics
NPI:1740568120
Name:THE SALEM MISSION, INC
Entity Type:Organization
Organization Name:THE SALEM MISSION, INC
Other - Org Name:LIFEBRIDGE NORTHSHORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF PROGRAMS AND COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:LYN
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:978-744-0500
Mailing Address - Street 1:56 MARGIN ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3341
Mailing Address - Country:US
Mailing Address - Phone:978-744-0500
Mailing Address - Fax:978-740-3832
Practice Address - Street 1:56 MARGIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-3341
Practice Address - Country:US
Practice Address - Phone:978-744-0500
Practice Address - Fax:978-740-3832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-02
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management