MEDICARE: SENIOR SOCIAL CLUB ON MORRISON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1386422517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENIOR SOCIAL CLUB ON MORRISON

Provider Business Mailing Address
First Line	:	5110 MORRISON RD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219-2241
Country	:	US
Telephone Number	:	720-933-4410
Fax Number	:

Provider Business Practice Location Address
First Line	:	5110 MORRISON RD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80219-2241
Country	:	US
Telephone Number	:	720-933-4410
Fax Number	:

Authorized Official
Title or Position	:	CFO AND PRESIDENT
Name	:	MUHAMMAD A ADUAN
Credential	:
Telephone Number	:	720-933-4410

Provider Enumeration Date	:	09/19/2023
Last Update Date	:	09/28/2023

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