Provider Demographics
NPI:1417514787
Name:SENIOR SOLUTION AGENCY LLC
Entity Type:Organization
Organization Name:SENIOR SOLUTION AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOO
Authorized Official - Middle Name:
Authorized Official - Last Name:EO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-313-0131
Mailing Address - Street 1:7 BROAD AVE SUITE 206
Mailing Address - Street 2:
Mailing Address - City:PALISADES PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07650-1886
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7 BROAD AVE SUITE 206
Practice Address - Street 2:
Practice Address - City:PALISADES PARK
Practice Address - State:NJ
Practice Address - Zip Code:07650-1886
Practice Address - Country:US
Practice Address - Phone:201-450-2195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SENIOR SOLUTION AGENCY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0658642Medicaid