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General NPI Number Information
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NPI Number | 1356651012
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Entity Type | Organization
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Legal Business Name | SENIOR OPTIONS GROUP
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Dates
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Enumeration Date | 10/15/2010
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Last Update Date | 10/15/2010
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Provider Practice Location Address
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Address Line | 4025 MARSHALL ROAD
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City | KETTERING
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State | OH
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Zip | 45440
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Country | US
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Telephone | 937-299-5555
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Fax | 937-299-2432
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Provider Business Mailing Address
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Address Line | 3571 TOWERWOOD COURT
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City | SPRINGFIELD
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State | OH
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Zip | 45503
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Country | US
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Telephone | 937-299-5555
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Fax | 937-299-2432
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Authorized Official
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Title or Position | OWNER
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Name | MS. KRISTINA CLUM
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Credential | R.N.
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Telephone | 937-299-5555
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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 |
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