Provider Demographics
NPI:1659922987
Name:SENIOR CARE MANAGEMENT, LLC
Entity Type:Organization
Organization Name:SENIOR CARE MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KEARN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-385-8503
Mailing Address - Street 1:600 E PASS RD STE B
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39507-3301
Mailing Address - Country:US
Mailing Address - Phone:228-239-1867
Mailing Address - Fax:
Practice Address - Street 1:600 E PASS RD STE B
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39507-3301
Practice Address - Country:US
Practice Address - Phone:228-385-8503
Practice Address - Fax:228-388-0106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care