Provider Demographics
NPI:1154553444
Name:SENIOR SERVICES LLC
Entity type:Organization
Organization Name:SENIOR SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:SURROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-349-3989
Mailing Address - Street 1:4102 MALAGA CT SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-1124
Mailing Address - Country:US
Mailing Address - Phone:505-349-3989
Mailing Address - Fax:505-892-4342
Practice Address - Street 1:4102 MALAGA CT SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1124
Practice Address - Country:US
Practice Address - Phone:505-349-3989
Practice Address - Fax:505-892-4342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2145253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care