ADULT FOSTER CARE OF THE NORTH SHORE, INC. (NPI# 1053430983) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053430983 |
| Entity Type | Organization |
| Organization Name | ADULT FOSTER CARE OF THE NORTH SHORE, INC. |
| Practice Address |
180 Main St Gloucester MA 01930-6002 |
| Practice Telephone | 9782812612 |
| Practice Fax Number | 9782812223 |
| Mailing Telephone | 9782812612 |
| Mailing Fax Number | 9782812223 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. CYNTHIA BJORLIE (DIRECTOR) |
| Authorized Official Telephone | 9782812612 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 1948636 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | ADULT FOSTER CARE OF THE NORTH SHORE, INC. | 63 Middle St, Gloucester, MA 01930 |
| Street Address |
180 MAIN ST |
| City | GLOUCESTER |
| State | MA |
| Zip Code | 01930-6002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609250356 | James Noble | Case Management | 180 Main St, Gloucester, MA 01930-6002 | 2015-07-13 |
| 1528302528 | Thomas John Connolly | Behavioral Analyst | 180 Main St, Gloucester, MA 01930-6002 | 2012-11-15 |
| 1174764831 | Action Incorporated | In Home Supportive Care | 180 Main St, Gloucester, MA 01930-6002 | 2009-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528538592 | Kimberly Moniz | Counselor | 3 & 4 Blackburn Center, Gloucester, MA 01930 | 2018-12-03 |
| 1770066714 | Anneliese Deckert | Counselor | 3 & 4 Blackburn Center Drive, Gloucester, MA 01930 | 2018-09-14 |
| 1497231070 | Erika Ackermann Duffy | Social Worker | Beeman Elementary School, 138 Cherry Street, Gloucester, MA 01930 | 2018-07-17 |
| 1639677958 | Sarah Bethany Stockwell | Counselor | 3 Blackburn Center Drive, Gloucester, MA 01930 | 2018-02-01 |
| 1164931721 | Samantha Carapellucci | Counselor | Children Friend Familes, 33 Commercial Street, Gloucester, MA 01930 | 2017-09-27 |
| 1215455860 | Jennifer Catherine Hynes | Social Worker | 33 Commercial Street, Gloucester, MA 01930 | 2017-09-05 |
| 1952829590 | Jessica Demarjian | Counselor | 24 Glemere Ave, Gloucester, MA 01930 | 2017-09-04 |
| 1033636600 | Anne Kirk Drueding | Social Worker | 29a Emerson Avenue, Gloucester, MA 01930 | 2017-08-24 |
| 1982128211 | Kristen Elizabeth Drischler | Registered Nurse | 29a Emerson Ave, Gloucester, MA 01930 | 2017-07-28 |
| 1992229207 | Jacqueline Marie Misuraca | Registered Nurse | 29 A Emerson Ave, Gloucester, MA 01930 | 2017-07-28 |
| Find all providers in zip 01930 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437794641 | Victoria Health Services Inc | Custodial Care Facility | 10 Chase Dr, Sharon, MA 02067-2903 | 2019-11-12 |
| 1376089169 | Theresa Kirby | Custodial Care Facility | 119 Robbins St, Milton, MA 02186-2535 | 2017-01-17 |
| 1518417138 | Helping Hand Adult Say Care Health Center Inc | Custodial Care Facility | 300 Hartwell St, Fall River, MA 02721-2912 | 2016-10-06 |
| 1750831681 | Sweet Home Corp | Custodial Care Facility | 112 Narragansett Blvd, Chicopee, MA 01013-2120 | 2016-10-04 |
| 1336592187 | Bamboo Adult Day Health | Custodial Care Facility | 185 Perkins St, Brockton, MA 02301 | 2016-07-18 |
| 1316390248 | Better Life At Home Inc. | Custodial Care Facility | 292 Salem St, Revere, MA 02151-1000 | 2016-07-15 |
| 1518350875 | Millennium Home Care LLC | Custodial Care Facility | 564 Main St Ste 203, Waltham, MA 02452-5559 | 2015-03-11 |
| 1750772570 | Chika Patience Okerekw-nwankwo | Custodial Care Facility | 22 Marion Street, Randolph, MA 02368 | 2015-02-16 |
| 1962809723 | Medicine On Time Corp. | Custodial Care Facility | 154 Lynnway Unit 508, Lynn, MA 01902-3447 | 2014-11-21 |
| 1467852640 | Good Shepherd Services | Custodial Care Facility | 103 Selwyn Rd, Randolph, MA 02368-5185 | 2014-08-26 |
| Find all providers with the same taxonomy | ||||
| City | GLOUCESTER |
| Zip Code | 01930 |
Please comment or provide details below to improve the information on ADULT FOSTER CARE OF THE NORTH SHORE, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.