Provider Demographics
NPI:1376913640
Name:SENIOR CITIZENS SERVICES OF NORTH TEXAS, INC.
Entity Type:Organization
Organization Name:SENIOR CITIZENS SERVICES OF NORTH TEXAS, INC.
Other - Org Name:THE KITCHEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-322-6232
Mailing Address - Street 1:PO BOX 1655
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76307-1655
Mailing Address - Country:US
Mailing Address - Phone:940-322-6232
Mailing Address - Fax:940-242-6121
Practice Address - Street 1:1000 BURNETT ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-3210
Practice Address - Country:US
Practice Address - Phone:940-322-6232
Practice Address - Fax:940-242-6212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals