Provider Demographics
NPI:1992127880
Name:KERNWOOD ADULT DAY CARE, INC.
Entity type:Organization
Organization Name:KERNWOOD ADULT DAY CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CORP. DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:SHERRILL
Authorized Official - Middle Name:ERIN
Authorized Official - Last Name:O'GORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-948-7383
Mailing Address - Street 1:51 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-1835
Mailing Address - Country:US
Mailing Address - Phone:978-948-7383
Mailing Address - Fax:978-948-3421
Practice Address - Street 1:112 KERNWOOD DR
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904-1711
Practice Address - Country:US
Practice Address - Phone:978-948-7383
Practice Address - Fax:978-948-3421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-10
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care