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General NPI Number Information
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NPI Number | 1851796163
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Entity Type | Organization
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Legal Business Name | SENIOR MOMENTS, LLC
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Dates
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Enumeration Date | 10/29/2014
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Last Update Date | 10/29/2014
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Provider Practice Location Address
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Address Line | 31 KINGSBURY AVE
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City | TOLLAND
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State | CT
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Zip | 06084
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Country | US
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Telephone | 860-926-4515
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Fax | 860-926-4517
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Provider Business Mailing Address
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Address Line | 750 MAIN ST
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City | MANCHESTER
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State | CT
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Zip | 06040-5101
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Country | US
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Telephone | 860-643-9500
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Fax | 860-643-5991
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | MS. LORI J O'CONNOR
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Credential | RN
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Telephone | 860-643-9500
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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 |
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License Number State |
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