Healthcare Provider Details

I. General information

NPI: 1750676029
Provider Name (Legal Business Name): SENIORS CENTRAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2011
Last Update Date: 06/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 JACK JONES STREET
AIKEN SC
29801
US

IV. Provider business mailing address

126 JACK JONES ST
AIKEN SC
29801-9012
US

V. Phone/Fax

Practice location:
  • Phone: 803-979-5022
  • Fax:
Mailing address:
  • Phone: 803-979-5022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateSC

VIII. Authorized Official

Name: MARK W HARRISON
Title or Position: PRESIDENT
Credential:
Phone: 803-979-5022