Provider Demographics
NPI:1518557222
Name:SHORELINE SENIOR SERVICES, LLC
Entity Type:Organization
Organization Name:SHORELINE SENIOR SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRANCHISE OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DELANCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-458-2992
Mailing Address - Street 1:2488 BOSTON POST RD STE 12A
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-1466
Mailing Address - Country:US
Mailing Address - Phone:203-458-2992
Mailing Address - Fax:203-458-2988
Practice Address - Street 1:2488 BOSTON POST RD STE 12A
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-1466
Practice Address - Country:US
Practice Address - Phone:203-458-2992
Practice Address - Fax:203-458-2988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care