Provider Demographics
NPI:1598048241
Name:SENIORBRIDGE FAMILY COMPANIES (FL), INC
Entity Type:Organization
Organization Name:SENIORBRIDGE FAMILY COMPANIES (FL), INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR ACCREDITATION PROFESSIONAL
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:STROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-301-2178
Mailing Address - Street 1:845 3RD AVE
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-6601
Mailing Address - Country:US
Mailing Address - Phone:212-994-6000
Mailing Address - Fax:
Practice Address - Street 1:2424 N FEDERAL HWY
Practice Address - Street 2:SUITE 251
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7735
Practice Address - Country:US
Practice Address - Phone:561-338-9399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUMANA AT HOME, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-20
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL299991549253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care