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General NPI Number Information
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NPI Number | 1720494842
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Entity Type | Organization
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Legal Business Name | SERVING SENIORS
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 07/09/2014
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Provider Practice Location Address
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Address Line | 1525 4TH AVE
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City | SAN DIEGO
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State | CA
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Zip | 92101-3107
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Country | US
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Telephone | 619-235-6538
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Fax | 619-544-9811
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Provider Business Mailing Address
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Address Line | 525 14TH ST SUITE 200
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City | SAN DIEGO
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State | CA
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Zip | 92101-7544
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Country | US
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Telephone | 619-235-6572
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Fax | 619-235-9829
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MR. PAUL DOWNEY
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Credential |
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Telephone | 619-487-0650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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