Provider Demographics
NPI:1528307626
Name:SENIOR PRO SERVICES LLC
Entity type:Organization
Organization Name:SENIOR PRO SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FESSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-357-2222
Mailing Address - Street 1:595 ESTUDILLO AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-4611
Mailing Address - Country:US
Mailing Address - Phone:510-357-2222
Mailing Address - Fax:510-667-9727
Practice Address - Street 1:595 ESTUDILLO AVE STE A
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-4611
Practice Address - Country:US
Practice Address - Phone:510-357-2222
Practice Address - Fax:510-667-9727
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SENIOR PRO SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-08
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health