Healthcare Provider Details

I. General information

NPI: 1881966646
Provider Name (Legal Business Name): SENIOR RESOURCE ASSOCIATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 08/23/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

686 14TH STREET
VERO BEACH, FL FL
32960-5770
US

IV. Provider business mailing address

694 14TH ST
VERO BEACH FL
32960-5770
US

V. Phone/Fax

Practice location:
  • Phone: 772-569-0760
  • Fax: 772-778-7272
Mailing address:
  • Phone: 772-569-0760
  • Fax: 772-778-7272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: KAREN DEIGL
Title or Position: CEO & PRESIDENT
Credential: MS
Phone: 772-569-0760