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General NPI Number Information
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NPI Number | 1164210696
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Entity Type | Organization
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Legal Business Name | SENIOR STAR TENANT DUBLIN CARE, LLC
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Dates
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Enumeration Date | 04/25/2025
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 6480 POST RD
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City | DUBLIN
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State | OH
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Zip | 43016-1682
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Country | US
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Telephone | 614-389-0308
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Fax |
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Provider Business Mailing Address
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Address Line | 1516 S BOSTON AVE STE 301
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City | TULSA
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State | OK
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Zip | 74119-4019
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Country | US
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Telephone | 918-592-4400
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | SHADOWOREE BETTS
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Credential |
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Telephone | 918-592-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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