Provider Demographics
NPI:1164436473
Name:SENIOR FRIENDSHIP CENTERS, INC
Entity Type:Organization
Organization Name:SENIOR FRIENDSHIP CENTERS, INC
Other - Org Name:HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:YINGLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-584-0030
Mailing Address - Street 1:2350 SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-1510
Mailing Address - Country:US
Mailing Address - Phone:941-584-0043
Mailing Address - Fax:941-496-8627
Practice Address - Street 1:2350 SCENIC DR
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-1510
Practice Address - Country:US
Practice Address - Phone:941-584-0043
Practice Address - Fax:941-496-8627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL053149900Medicaid