Provider Demographics
NPI:1417218512
Name:SENIOR HEALTH CONSULTANTS INC
Entity Type:Organization
Organization Name:SENIOR HEALTH CONSULTANTS INC
Other - Org Name:THRIVING INVESTMENTS INC
Other - Org Type:Other Name
Authorized Official - Title/Position:SOLE EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:VIJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:JETHANANDANI
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:865-219-6968
Mailing Address - Street 1:2620 MINERAL SPRINGS AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-1569
Mailing Address - Country:US
Mailing Address - Phone:865-219-6968
Mailing Address - Fax:865-219-8636
Practice Address - Street 1:2620 MINERAL SPRINGS AVE
Practice Address - Street 2:SUITE A
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-1569
Practice Address - Country:US
Practice Address - Phone:865-219-6968
Practice Address - Fax:865-219-8636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0196652084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1932187143OtherNPI
TN3043268OtherMEDICARE
TN3043268Medicaid
TNB37271OtherUPIN