Provider Demographics
NPI:1801881768
Name:CORCORAN HOUSE
Entity type:Organization
Organization Name:CORCORAN HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXCUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LUSCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-365-3600
Mailing Address - Street 1:40 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01510-2995
Mailing Address - Country:US
Mailing Address - Phone:978-365-3600
Mailing Address - Fax:978-365-9800
Practice Address - Street 1:40 WALNUT ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MA
Practice Address - Zip Code:01510-2995
Practice Address - Country:US
Practice Address - Phone:978-365-3600
Practice Address - Fax:978-365-9800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1903756310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility