Provider Demographics
NPI:1245774330
Name:HELPING OUR SEASONED SENIORS THRIVE, LLC
Entity type:Organization
Organization Name:HELPING OUR SEASONED SENIORS THRIVE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-409-9286
Mailing Address - Street 1:8112 ALLENDALE DR
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-4206
Mailing Address - Country:US
Mailing Address - Phone:202-409-9286
Mailing Address - Fax:
Practice Address - Street 1:8112 ALLENDALE DR
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-4206
Practice Address - Country:US
Practice Address - Phone:202-409-9286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care