Provider Demographics
NPI:1023755469
Name:SENIOR CARE THERAPY LLC
Entity type:Organization
Organization Name:SENIOR CARE THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-264-0023
Mailing Address - Street 1:85 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-2437
Mailing Address - Country:US
Mailing Address - Phone:973-264-0023
Mailing Address - Fax:973-264-0022
Practice Address - Street 1:12030 N 111TH WAY
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-3088
Practice Address - Country:US
Practice Address - Phone:973-264-0023
Practice Address - Fax:973-264-0022
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SENIOR CARE THERAPY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-17
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1730439639OtherPROVIDER NPI