Provider Demographics
NPI:1184927782
Name:SENIOR SAFETYPRO
Entity type:Organization
Organization Name:SENIOR SAFETYPRO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:FOOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-401-1170
Mailing Address - Street 1:6820 MONTE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92277-6593
Mailing Address - Country:US
Mailing Address - Phone:760-401-1170
Mailing Address - Fax:888-343-3770
Practice Address - Street 1:7030 E 54TH PL
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-4806
Practice Address - Country:US
Practice Address - Phone:800-971-6571
Practice Address - Fax:888-343-3770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty