Provider Demographics
NPI:1649987983
Name:ZION HEALTHCARE LLC
Entity type:Organization
Organization Name:ZION HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TITUS
Authorized Official - Middle Name:J
Authorized Official - Last Name:OLUWASUYI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:781-632-5130
Mailing Address - Street 1:64 BALDWIN ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-3627
Mailing Address - Country:US
Mailing Address - Phone:781-632-5130
Mailing Address - Fax:
Practice Address - Street 1:64 BALDWIN ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-3627
Practice Address - Country:US
Practice Address - Phone:781-632-5130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency