Mishawum Assisted Living Assoc., LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MISHAWUM ASSISTED LIVING ASSOC., LLC

Doing business as

Zelma Lacey House

Practice address

9 W School St
Charlestown, MA 02129-2902

Phone

(617) 241-0328

Fax

(617) 241-0329

NPI assigned

Apr 10, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Margaret Driscoll

Title

Executive Director

Phone

(617) 241-0328

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Zelma Lacey House Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346463452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 W SCHOOL ST",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021292902",
            "telephone_number": "617-241-0328",
            "fax_number": "617-241-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 W SCHOOL ST",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021292902",
            "telephone_number": "617-241-0328",
            "fax_number": "617-241-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISHAWUM ASSISTED LIVING ASSOC., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DRISCOLL",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "617-241-0328"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1900561",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Zelma Lacey House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Charlestown, MA
• Providers in Charlestown, MA by specialty
• Assisted Living Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.