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General NPI Number Information
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NPI Number | 1497041388
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Entity Type | Organization
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Legal Business Name | COMPLETE SENIOR CARE
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Dates
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Enumeration Date | 06/20/2011
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Last Update Date | 04/07/2016
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Provider Practice Location Address
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Address Line | 1302 MAIN ST
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City | NIAGARA FALLS
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State | NY
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Zip | 14301-1118
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Country | US
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Telephone | 716-285-8224
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Fax | 716-285-8232
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Provider Business Mailing Address
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Address Line | 1302 MAIN ST
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City | NIAGARA FALLS
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State | NY
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Zip | 14301-1118
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Country | US
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Telephone | 716-285-8224
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Fax | 716-285-8232
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Authorized Official
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Title or Position | CONTROLLER
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Name | MR. KEVIN RONALD DAFOE
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Credential |
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Telephone | 716-285-8224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State | NY
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