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General NPI Number Information
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NPI Number | 1063704831
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Entity Type | Organization
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Legal Business Name | SENIOR CAR
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Dates
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Enumeration Date | 05/11/2011
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | 432 ROXBURY CIR
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City | JACKSON
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State | MI
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Zip | 49201
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Country | US
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Telephone | 708-480-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 432 ROXBURY CIR
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City | JACKSON
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State | MI
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Zip | 49203-7189
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Country | US
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Telephone | 708-480-2273
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | FELICIA THOMAS I
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Credential |
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Telephone | 708-480-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | MI
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