Provider Demographics
NPI:1871920504
Name:SENIOR SERVICES OF VAN BUREN CO.
Entity type:Organization
Organization Name:SENIOR SERVICES OF VAN BUREN CO.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:CARVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-637-3607
Mailing Address - Street 1:220 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49090-2511
Mailing Address - Country:US
Mailing Address - Phone:269-637-3607
Mailing Address - Fax:269-637-0218
Practice Address - Street 1:220 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SOUTH HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49090-2511
Practice Address - Country:US
Practice Address - Phone:269-637-3607
Practice Address - Fax:269-637-0218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care