Healthcare Provider Details

I. General information

NPI: 1043652894
Provider Name (Legal Business Name): SENIOR MATTERS EXTENDED CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 10/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2711 MIDDLEBURG DR SUITE 201
COLUMBIA SC
29204-2413
US

IV. Provider business mailing address

2711 MIDDLEBURG DR SUITE 201
COLUMBIA SC
29204-2413
US

V. Phone/Fax

Practice location:
  • Phone: 803-765-1838
  • 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: HEATHER FUTCH
Title or Position: DIR. OF CASE MGMT. & NON-MED. SERVI
Credential:
Phone: 803-765-1838