Provider Demographics
NPI:1609178599
Name:SENIOR STAR CORP. SOCIAL DAY
Entity Type:Organization
Organization Name:SENIOR STAR CORP. SOCIAL DAY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIPNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-434-0041
Mailing Address - Street 1:1676 N OLDEN AVE
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-3209
Mailing Address - Country:US
Mailing Address - Phone:609-434-0041
Mailing Address - Fax:609-434-0043
Practice Address - Street 1:1676 N OLDEN AVE
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08638-3209
Practice Address - Country:US
Practice Address - Phone:609-434-0041
Practice Address - Fax:609-434-0043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-26
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0431311Medicaid