Provider Demographics
NPI:1558402461
Name:COMMUNITY & SENIOR SERVICES
Entity Type:Organization
Organization Name:COMMUNITY & SENIOR SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:IVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-689-6693
Mailing Address - Street 1:3301 SINCLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-6620
Mailing Address - Country:US
Mailing Address - Phone:432-689-6693
Mailing Address - Fax:432-689-6699
Practice Address - Street 1:3301 SINCLAIR AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-6620
Practice Address - Country:US
Practice Address - Phone:432-689-6693
Practice Address - Fax:432-689-6699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals