Provider Demographics
NPI:1578856076
Name:SENIOR SOLUTIONS HOME CARE LLC
Entity Type:Organization
Organization Name:SENIOR SOLUTIONS HOME CARE LLC
Other - Org Name:SENIOR SOLUTIONS HOME CARE LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARMELETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOFTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-573-7403
Mailing Address - Street 1:323 PINE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-2595
Mailing Address - Country:US
Mailing Address - Phone:229-573-7403
Mailing Address - Fax:229-735-7404
Practice Address - Street 1:323 PINE AVE STE 100
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-2595
Practice Address - Country:US
Practice Address - Phone:229-573-7403
Practice Address - Fax:229-573-7404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047-R-0821251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003132752Medicaid
GA003132752BMedicaid