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General NPI Number Information
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NPI Number | 1992933451
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Entity Type | Organization
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Legal Business Name | MORRISTOWN SENIOR SERVICES
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Dates
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Enumeration Date | 06/23/2009
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Last Update Date | 06/23/2009
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Provider Practice Location Address
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Address Line | 739 E. 2ND ST.
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City | MORRISTOWN
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State | TN
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Zip | 37814
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Country | US
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Telephone | 423-581-7075
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Fax | 423-581-7964
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Provider Business Mailing Address
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Address Line | 739 E. 2ND ST.
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City | MORRISTOWN
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State | TN
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Zip | 37814
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Country | US
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Telephone | 423-581-7075
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Fax | 423-581-7964
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Authorized Official
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Title or Position | CFO
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Name | THOMAS P. BOLER
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Credential |
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Telephone | 423-238-8087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 0000000288
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License Number State | TN
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