Provider Demographics
NPI:1972831766
Name:SENIOR CARE BEHAVIORAL NETWORK LLC
Entity type:Organization
Organization Name:SENIOR CARE BEHAVIORAL NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:SCHAIRER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:267-210-1170
Mailing Address - Street 1:2058 MAPLE AVE APT J1-12
Mailing Address - Street 2:
Mailing Address - City:HATFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19440-1583
Mailing Address - Country:US
Mailing Address - Phone:267-210-1170
Mailing Address - Fax:800-234-1627
Practice Address - Street 1:2058 MAPLE AVE APT J1-12
Practice Address - Street 2:
Practice Address - City:HATFIELD
Practice Address - State:PA
Practice Address - Zip Code:19440-1583
Practice Address - Country:US
Practice Address - Phone:267-210-1170
Practice Address - Fax:800-234-1627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty