Provider Demographics
NPI:1639042146
Name:SILVER FOX SENIOR SOCIAL CLUB INC
Entity type:Organization
Organization Name:SILVER FOX SENIOR SOCIAL CLUB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-635-5335
Mailing Address - Street 1:22 E GENESEE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-2540
Mailing Address - Country:US
Mailing Address - Phone:315-635-5335
Mailing Address - Fax:
Practice Address - Street 1:240 W SENECA ST
Practice Address - Street 2:
Practice Address - City:MANLIUS
Practice Address - State:NY
Practice Address - Zip Code:13104-3401
Practice Address - Country:US
Practice Address - Phone:315-715-5335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SILVER FOX SENIOR SOCIAL CLUB INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care