Provider Demographics
NPI:1588668834
Name:SENIOR CARE SERVICES, INC
Entity type:Organization
Organization Name:SENIOR CARE SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP CFO
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-303-9000
Mailing Address - Street 1:1413 EAST I 30
Mailing Address - Street 2:STE 7
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-4598
Mailing Address - Country:US
Mailing Address - Phone:972-303-9000
Mailing Address - Fax:972-303-9992
Practice Address - Street 1:2244 BRINKER RD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76208-6120
Practice Address - Country:US
Practice Address - Phone:972-303-9000
Practice Address - Fax:972-303-9992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101682314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1653115-01OtherNHIC COINS
TX1653115-02OtherTMHP COINS
TX001012210Medicaid
TXHH179SOtherBCBS
TX675995Medicare Oscar/Certification
TXHH179SOtherBCBS