Provider Demographics
NPI:1932300639
Name:SENIOR SERVICES, INC
Entity Type:Organization
Organization Name:SENIOR SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIB
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:269-382-0515
Mailing Address - Street 1:918 JASPER ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-2853
Mailing Address - Country:US
Mailing Address - Phone:269-382-0515
Mailing Address - Fax:
Practice Address - Street 1:918 JASPER ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-2853
Practice Address - Country:US
Practice Address - Phone:269-382-0515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801082552251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health