Provider Demographics
NPI:1790266989
Name:ASIAN AMERICAN SENIOR SOCIAL SERVICE FOUNDATION
Entity Type:Organization
Organization Name:ASIAN AMERICAN SENIOR SOCIAL SERVICE FOUNDATION
Other - Org Name:AA ADULT DAYCARE AND DAY ACTIVITY AND HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:INSOOK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-583-3260
Mailing Address - Street 1:11500 N STEMMONS FWY STE 180
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-2185
Mailing Address - Country:US
Mailing Address - Phone:469-583-3260
Mailing Address - Fax:
Practice Address - Street 1:11500 N STEMMONS FWY STE 180
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-2185
Practice Address - Country:US
Practice Address - Phone:469-583-3260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX150210261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care