Provider Demographics
NPI:1942335807
Name:FAMILY SENIOR HEALTH LLC
Entity Type:Organization
Organization Name:FAMILY SENIOR HEALTH LLC
Other - Org Name:DBA SENIOR SPIRIT OF JERSEY CITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUISA
Authorized Official - Middle Name:U
Authorized Official - Last Name:SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:BS, CALA, ADC
Authorized Official - Phone:201-761-0280
Mailing Address - Street 1:675 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305
Mailing Address - Country:US
Mailing Address - Phone:201-761-0280
Mailing Address - Fax:201-761-0290
Practice Address - Street 1:675 GARFIELD AVE
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305
Practice Address - Country:US
Practice Address - Phone:201-761-0280
Practice Address - Fax:201-761-0290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ408331261QA0600X, 313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility