Provider Demographics
NPI:1427360817
Name:SUPPORTS FOR SENIORS LLC
Entity Type:Organization
Organization Name:SUPPORTS FOR SENIORS LLC
Other - Org Name:COMMUNITY ALTERNATIVES CONSORTIUM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CAO/OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DENESHA
Authorized Official - Middle Name:SHANETTE
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:804-437-2187
Mailing Address - Street 1:6536 KINGS GROVE CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-7894
Mailing Address - Country:US
Mailing Address - Phone:804-437-2187
Mailing Address - Fax:
Practice Address - Street 1:3122 W CLAY ST STE 22
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4725
Practice Address - Country:US
Practice Address - Phone:877-467-0088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities