Provider Demographics
NPI:1497164107
Name:SENIOR MEALS & SERVICES
Entity Type:Organization
Organization Name:SENIOR MEALS & SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:HEJLIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-662-5061
Mailing Address - Street 1:202 4TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301
Mailing Address - Country:US
Mailing Address - Phone:701-662-5061
Mailing Address - Fax:
Practice Address - Street 1:202 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301
Practice Address - Country:US
Practice Address - Phone:701-662-5061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDJKL907347B00000X
NDHPP847347B00000X
NDJZA790347B00000X
NDJFJ887347B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus