Provider Demographics
NPI:1770353724
Name:SENIOR911
Entity type:Organization
Organization Name:SENIOR911
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SOJNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-330-3599
Mailing Address - Street 1:4122 CHATTAHOOCHEE TRCE STE 202
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-2132
Mailing Address - Country:US
Mailing Address - Phone:470-330-3599
Mailing Address - Fax:
Practice Address - Street 1:4122 CHATTAHOOCHEE TRCE STE 202
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-2132
Practice Address - Country:US
Practice Address - Phone:470-330-3599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care