Provider Demographics
NPI:1194844720
Name:SENIOR NETWORK, INC.
Entity type:Organization
Organization Name:SENIOR NETWORK, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:MUECK
Authorized Official - Last Name:LAKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-749-7611
Mailing Address - Street 1:11665 DOOLITTLE DR
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-2898
Mailing Address - Country:US
Mailing Address - Phone:301-638-0502
Mailing Address - Fax:301-970-2459
Practice Address - Street 1:11665 DOOLITTLE DR
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2898
Practice Address - Country:US
Practice Address - Phone:301-638-0502
Practice Address - Fax:301-970-2459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17311261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care