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General NPI Number Information
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NPI Number | 1083005367
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Entity Type | Organization
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Legal Business Name | SENIOR SERVICES FOR SOUTH SOUND
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Dates
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Enumeration Date | 02/09/2015
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Last Update Date | 02/09/2015
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Provider Practice Location Address
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Address Line | 222 COLUMBIA ST NW
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City | OLYMPIA
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State | WA
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Zip | 98501-8208
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Country | US
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Telephone | 360-586-6181
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Fax | 360-586-7408
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Provider Business Mailing Address
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Address Line | 222 COLUMBIA ST NW
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City | OLYMPIA
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State | WA
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Zip | 98501-8208
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Country | US
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Telephone | 360-586-6181
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Fax | 360-586-7408
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | EILEEN MCKENZIESULLIVAN
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Credential |
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Telephone | 360-586-6181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | DNA
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License Number State | WA
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