Provider Demographics
NPI:1306398656
Name:NAPERVILLE SENIOR CENTER ADULT DAY SERVICES
Entity Type:Organization
Organization Name:NAPERVILLE SENIOR CENTER ADULT DAY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BUSINESS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-857-3017
Mailing Address - Street 1:1504 N NAPER BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-4819
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1504 N NAPER BLVD STE 120
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-4819
Practice Address - Country:US
Practice Address - Phone:630-587-3017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care