- Enrollment id
- O20030514000073
- Enrollment state
- MA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1881692663
- Multiple npi flag
- N
- Ccn
- 225224
- Associate id
- 0547170193
- Organization name
- 19 VARNUM STREET OPERATING COMPANY, LLC
- Doing business as name
- LOWELL HEALTH CARE CENTER
- Incorporation date
- 2003-01-10
- Incorporation state
- DE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- CARE ONE AT LOWELL
- Affiliation entity name
- CAREONE
- Affiliation entity id
- 109
- Address line 1
- 19 VARNUM STREET
- Address line 2
- LOWELL HEALTH CARE CENTER
- City
- LOWELL
- State
- MA
- Zip code
- 018502132