Provider Demographics
NPI:1821447897
Name:GREATER LYNN SENIOR SERVICES INC
Entity Type:Organization
Organization Name:GREATER LYNN SENIOR SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DATA APPLICATION SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:M
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-586-8505
Mailing Address - Street 1:8 SILSBEE ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1404
Mailing Address - Country:US
Mailing Address - Phone:781-599-0110
Mailing Address - Fax:
Practice Address - Street 1:8 SILSBEE ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1404
Practice Address - Country:US
Practice Address - Phone:781-599-0110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-09
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1028874251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1811024637Medicaid