Provider Demographics
NPI:1316517204
Name:SENECARE LLC
Entity type:Organization
Organization Name:SENECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOSEFINA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-508-1514
Mailing Address - Street 1:616 S DEL MAR AVE STE E
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-2484
Mailing Address - Country:US
Mailing Address - Phone:626-508-1514
Mailing Address - Fax:626-508-1519
Practice Address - Street 1:616 S DEL MAR AVE STE E
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-2484
Practice Address - Country:US
Practice Address - Phone:626-508-1514
Practice Address - Fax:626-508-1519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care