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General NPI Number Information
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NPI Number | 1356872766
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Entity Type | Organization
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Legal Business Name | SENIOR HEALTH ASSOCIATES
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Dates
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Enumeration Date | 03/27/2017
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Last Update Date | 03/27/2017
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Provider Practice Location Address
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Address Line | 335 PLEASANT POINT DR
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City | BEAUFORT
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State | SC
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Zip | 29907-1164
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Country | US
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Telephone | 803-757-1173
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Fax |
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Provider Business Mailing Address
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Address Line | 335 PLEASANT POINT DR
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City | BEAUFORT
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State | SC
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Zip | 29907-1164
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | TRACY OWENS
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Credential |
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Telephone | 803-757-1173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 20784
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 20784
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 20784
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License Number State | SC
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