Provider Demographics
NPI:1801014600
Name:NORTH SHORE ELDER SERVICES, INC.
Entity Type:Organization
Organization Name:NORTH SHORE ELDER SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BRINDAMOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-624-2237
Mailing Address - Street 1:152 SYLVAN ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3568
Mailing Address - Country:US
Mailing Address - Phone:978-750-4540
Mailing Address - Fax:978-750-8053
Practice Address - Street 1:152 SYLVAN ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3568
Practice Address - Country:US
Practice Address - Phone:978-750-4540
Practice Address - Fax:978-750-8053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1902016Medicaid