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General NPI Number Information
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NPI Number | 1497371231
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Entity Type | Organization
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Legal Business Name | 1ST SENIORS LLC
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Dates
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Enumeration Date | 06/17/2020
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Last Update Date | 06/17/2020
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Provider Practice Location Address
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Address Line | 3131 GRAPE RD
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City | MISHAWAKA
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State | IN
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Zip | 46545-8834
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Country | US
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Telephone | 574-239-2273
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Fax | 574-239-7973
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Provider Business Mailing Address
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Address Line | 51535 STEEPLE CHASE CT
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City | GRANGER
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State | IN
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Zip | 46530-8302
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Country | US
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Telephone | 574-904-1585
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CARE MANAGEMENT
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Name | ANN HALEY
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Credential | RN
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Telephone | 574-344-9916
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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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