Healthcare Provider Details

I. General information

NPI: 1104787589
Provider Name (Legal Business Name): SENIOR SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 BEAUMONT AVE UNIT A2-343
BEAUMONT CA
92223-6820
US

IV. Provider business mailing address

1440 BEAUMONT AVE UNIT A2-343
BEAUMONT CA
92223-6820
US

V. Phone/Fax

Practice location:
  • Phone: 310-595-4174
  • Fax:
Mailing address:
  • Phone: 310-595-4174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CAROLYN BURRELL
Title or Position: MANAGER
Credential: MBA, EJD, RCFE ADMIN
Phone: 310-595-4174