Provider Demographics
NPI:1558493007
Name:SENIOR MANAGEMENT INC
Entity Type:Organization
Organization Name:SENIOR MANAGEMENT INC
Other - Org Name:STAGE COACH MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BUDDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOCKAMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-814-1223
Mailing Address - Street 1:PO BOX 877
Mailing Address - Street 2:
Mailing Address - City:ANGIER
Mailing Address - State:NC
Mailing Address - Zip Code:27501-0877
Mailing Address - Country:US
Mailing Address - Phone:910-814-1223
Mailing Address - Fax:910-814-1223
Practice Address - Street 1:6828 OLD STAGE RD N
Practice Address - Street 2:
Practice Address - City:ANGIER
Practice Address - State:NC
Practice Address - Zip Code:27501-7496
Practice Address - Country:US
Practice Address - Phone:910-814-1223
Practice Address - Fax:910-814-1223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL043020310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7805017Medicaid