Provider Demographics
NPI:1174194765
Name:SENIOR HOME SHARING, INC.
Entity Type:Organization
Organization Name:SENIOR HOME SHARING, INC.
Other - Org Name:SENIOR HOME SHARING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROSNAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:630-407-0440
Mailing Address - Street 1:1910 S HIGHLAND AVE STE 135
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-6147
Mailing Address - Country:US
Mailing Address - Phone:630-407-0440
Mailing Address - Fax:
Practice Address - Street 1:1910 S HIGHLAND AVE STE 135
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-6147
Practice Address - Country:US
Practice Address - Phone:630-407-0440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-06
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No310400000XNursing & Custodial Care FacilitiesAssisted Living FacilityGroup - Single Specialty