Provider Demographics
NPI:1396864815
Name:SENIOR CITIZENS COMMUNITY CENTER
Entity Type:Organization
Organization Name:SENIOR CITIZENS COMMUNITY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSEANN
Authorized Official - Middle Name:JOSEPHINE
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-327-5824
Mailing Address - Street 1:112 E MARION ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:MO
Mailing Address - Zip Code:65275-1041
Mailing Address - Country:US
Mailing Address - Phone:660-327-5824
Mailing Address - Fax:660-327-1025
Practice Address - Street 1:112 E MARION ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:MO
Practice Address - Zip Code:65275-1041
Practice Address - Country:US
Practice Address - Phone:660-327-5824
Practice Address - Fax:660-327-1025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO14299127261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service