Provider Demographics
NPI:1518556703
Name:SENIOR CENTERS INC.
Entity Type:Organization
Organization Name:SENIOR CENTERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOY GRISSOM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:419-242-9511
Mailing Address - Street 1:2308 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-5035
Mailing Address - Country:US
Mailing Address - Phone:419-242-9511
Mailing Address - Fax:419-242-9513
Practice Address - Street 1:2308 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-5035
Practice Address - Country:US
Practice Address - Phone:419-242-9511
Practice Address - Fax:419-242-9513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)