Provider Demographics
NPI:1447392352
Name:SAVANNAH SENIORS INC.
Entity Type:Organization
Organization Name:SAVANNAH SENIORS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:CANTY
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:843-662-7851
Mailing Address - Street 1:2620 ALLIGATOR RD
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:SC
Mailing Address - Zip Code:29541-4313
Mailing Address - Country:US
Mailing Address - Phone:843-662-7851
Mailing Address - Fax:843-662-3140
Practice Address - Street 1:2620 ALLIGATOR RD
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:SC
Practice Address - Zip Code:29541-4313
Practice Address - Country:US
Practice Address - Phone:843-662-7851
Practice Address - Fax:843-662-3140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCADC219261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCADC219OtherDHEC LICENCE
SCEX0715Medicaid