Provider Demographics
NPI:1023516465
Name:D'YOUVILLE LEADERSHIP SOLUTIONS
Entity type:Organization
Organization Name:D'YOUVILLE LEADERSHIP SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:PRENDERGAST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-569-1000
Mailing Address - Street 1:981 VARNUM AVE
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-1913
Mailing Address - Country:US
Mailing Address - Phone:978-569-1000
Mailing Address - Fax:978-569-1085
Practice Address - Street 1:1085 VARNUM AVE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-1133
Practice Address - Country:US
Practice Address - Phone:978-569-1016
Practice Address - Fax:978-569-1015
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:-
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility