Healthcare Provider Details

I. General information

NPI: 1912707522
Provider Name (Legal Business Name): SENIOR CENTER DAYCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2025
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10606 AUSTIN AVE
CHICAGO RIDGE IL
60415-1911
US

IV. Provider business mailing address

10606 AUSTIN AVE
CHICAGO RIDGE IL
60415-1911
US

V. Phone/Fax

Practice location:
  • Phone: 708-299-6543
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: MAISOUN FARHOUD
Title or Position: PRESIDENT
Credential:
Phone: 708-299-6543