Healthcare Provider Details

I. General information

NPI: 1972831766
Provider Name (Legal Business Name): SENIOR CARE BEHAVIORAL NETWORK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2009
Last Update Date: 12/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2058 MAPLE AVE APT J1-12
HATFIELD PA
19440-1583
US

IV. Provider business mailing address

2058 MAPLE AVE APT J1-12
HATFIELD PA
19440-1583
US

V. Phone/Fax

Practice location:
  • Phone: 267-210-1170
  • Fax: 800-234-1627
Mailing address:
  • Phone: 267-210-1170
  • Fax: 800-234-1627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JAMES MARTIN SCHAIRER
Title or Position: SOLE MEMBER
Credential: LCSW
Phone: 267-210-1170