Provider Demographics
NPI:1326210329
Name:SENIOR VENTURES & MANAGEMENT INC
Entity Type:Organization
Organization Name:SENIOR VENTURES & MANAGEMENT INC
Other - Org Name:BIG ELM RETIREMENT & NURSING CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:GATEWOOD
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:704-932-0000
Mailing Address - Street 1:1285 W A ST
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28081-9501
Mailing Address - Country:US
Mailing Address - Phone:704-932-0000
Mailing Address - Fax:704-938-6039
Practice Address - Street 1:1285 W A ST
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28081-9501
Practice Address - Country:US
Practice Address - Phone:704-932-0000
Practice Address - Fax:704-938-6039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0471314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3416505Medicaid
NC3416505Medicaid