Provider Demographics
NPI:1942450101
Name:SENIOR SERVICES PLUS HEALTH CARE, INC.
Entity Type:Organization
Organization Name:SENIOR SERVICES PLUS HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:MC KILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-373-3390
Mailing Address - Street 1:P.O. BOX 1676
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53547-1676
Mailing Address - Country:US
Mailing Address - Phone:608-373-3390
Mailing Address - Fax:608-757-5948
Practice Address - Street 1:120 N CROSBY AVE
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-3375
Practice Address - Country:US
Practice Address - Phone:608-373-3390
Practice Address - Fax:608-757-5948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1066251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43114600Medicaid