MEDICARE: SOCIAL SENIORS ADULT DAY CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center	NONE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942458310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOCIAL SENIORS ADULT DAY CENTER LLC

Provider Business Mailing Address
First Line	:	1396 S HIGH ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-1042
Country	:	US
Telephone Number	:	614-270-7308
Fax Number	:

Provider Business Practice Location Address
First Line	:	1396 S HIGH ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-1042
Country	:	US
Telephone Number	:	614-270-7308
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. SVETLANA YURCHAK
Credential	:
Telephone Number	:	614-270-7308

Provider Enumeration Date	:	08/28/2008
Last Update Date	:	08/28/2008

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