Provider Demographics
NPI:1447458112
Name:SENIOR CARE OF OWENSBORO
Entity type:Organization
Organization Name:SENIOR CARE OF OWENSBORO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEVI
Authorized Official - Middle Name:A
Authorized Official - Last Name:REAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-685-5045
Mailing Address - Street 1:401 FREDERICA ST BLDG B
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-6298
Mailing Address - Country:US
Mailing Address - Phone:270-685-5045
Mailing Address - Fax:270-685-5012
Practice Address - Street 1:401 FREDERICA STREET BUILDING B
Practice Address - Street 2:SUITE 102
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-3050
Practice Address - Country:US
Practice Address - Phone:270-685-5045
Practice Address - Fax:270-685-5012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-04
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health