Provider Demographics
NPI:1699373225
Name:SENIOR ALLY, INC.
Entity Type:Organization
Organization Name:SENIOR ALLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DELICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:708-462-2215
Mailing Address - Street 1:600 HOLIDAY PLAZA DR STE 177
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-2236
Mailing Address - Country:US
Mailing Address - Phone:708-462-2215
Mailing Address - Fax:
Practice Address - Street 1:600 HOLIDAY PLAZA DR STE 177
Practice Address - Street 2:
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443-2236
Practice Address - Country:US
Practice Address - Phone:708-462-2215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care