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General NPI Number Information
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NPI Number | 1710199336
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Entity Type | Organization
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Legal Business Name | DYNAMIC SENIORS, INC.
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 4729 ALLEN RD
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City | ZEPHYRHILLS
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State | FL
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Zip | 33541-3555
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Country | US
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Telephone | 813-782-8843
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Fax | 813-782-8843
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Provider Business Mailing Address
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Address Line | 4729 ALLEN RD
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City | ZEPHYRHILLS
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State | FL
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Zip | 33541-3555
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Country | US
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Telephone | 813-782-8843
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Fax | 813-782-8843
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Authorized Official
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Title or Position | OWNER-ADMINISTRATOR
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Name | MS. TERESA LYNN WARMKE
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Credential | OTR-L
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Telephone | 813-973-8151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 9000
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License Number State | FL
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