Provider Demographics
NPI:1417507823
Name:SENIOR MOMENTS
Entity Type:Organization
Organization Name:SENIOR MOMENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR SAFETY ADVISOR
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:WHITNEY
Authorized Official - Suffix:
Authorized Official - Credentials:SHSS
Authorized Official - Phone:509-392-3232
Mailing Address - Street 1:3617 PLAZA WAY STE H
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-2717
Mailing Address - Country:US
Mailing Address - Phone:509-392-3232
Mailing Address - Fax:
Practice Address - Street 1:3617 PLAZA WAY STE H
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-2717
Practice Address - Country:US
Practice Address - Phone:509-392-3232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty