Provider Demographics
NPI:1841530136
Name:AGING AND DISABILITY RESOURCE CONSORTIUM OF THE GREATER NORTH SHORE, I
Entity type:Organization
Organization Name:AGING AND DISABILITY RESOURCE CONSORTIUM OF THE GREATER NORTH SHORE, I
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:T
Authorized Official - Last Name:CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-586-8526
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:781-586-8526
Mailing Address - Fax:781-592-7540
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:781-586-8526
Practice Address - Fax:781-592-7540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care