Provider Demographics
NPI:1508043316
Name:SENIOR MANAGEMENT LLC
Entity Type:Organization
Organization Name:SENIOR MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOLLOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-472-6011
Mailing Address - Street 1:PO BOX 231
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:KY
Mailing Address - Zip Code:41006-0231
Mailing Address - Country:US
Mailing Address - Phone:859-472-6011
Mailing Address - Fax:859-472-6030
Practice Address - Street 1:213 MAIN ST.
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:KY
Practice Address - Zip Code:41006-0231
Practice Address - Country:US
Practice Address - Phone:859-472-6011
Practice Address - Fax:859-472-6030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100360311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY100360OtherKY.ST.LICENSE NUMBER