Provider Demographics
NPI:1104244938
Name:SENIOR MANAGEMENT SYSTEMS LLC
Entity type:Organization
Organization Name:SENIOR MANAGEMENT SYSTEMS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:VISKER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, AGPCNP-BC
Authorized Official - Phone:801-210-0506
Mailing Address - Street 1:728 E 2900 N
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-3927
Mailing Address - Country:US
Mailing Address - Phone:801-210-0506
Mailing Address - Fax:801-335-5125
Practice Address - Street 1:728 E 2900 N
Practice Address - Street 2:
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-3927
Practice Address - Country:US
Practice Address - Phone:801-210-0506
Practice Address - Fax:801-335-5125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-29
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2300X, 1041C0700X
UT264688-8900363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty