Healthcare Provider Details

I. General information

NPI: 1184927782
Provider Name (Legal Business Name): SENIOR SAFETYPRO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2010
Last Update Date: 12/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7030 E 54TH PL
COMMERCE CITY CO
80022-4806
US

IV. Provider business mailing address

6820 MONTE VISTA DR
TWENTYNINE PALMS CA
92277-6593
US

V. Phone/Fax

Practice location:
  • Phone: 800-971-6571
  • Fax: 888-343-3770
Mailing address:
  • Phone: 760-401-1170
  • Fax: 888-343-3770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number StateTX

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SHERRY L FOOSE
Title or Position: OWNER
Credential:
Phone: 760-401-1170