Healthcare Provider Details

I. General information

NPI: 1962310961
Provider Name (Legal Business Name): SENIOR LIFE SOMERSET, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 ROUTE 202/206
BRIDGEWATER NJ
08807-1763
US

IV. Provider business mailing address

401 BROAD ST
JOHNSTOWN PA
15906-2745
US

V. Phone/Fax

Practice location:
  • Phone: 814-535-6000
  • Fax: 814-535-6000
Mailing address:
  • Phone: 814-535-6000
  • Fax: 814-535-6000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DAVID MICHAEL DODSON
Title or Position: CFO
Credential: CPA
Phone: 814-535-6000