Provider Demographics
NPI:1801972906
Name:SENEX FOUNDATION, INC.
Entity type:Organization
Organization Name:SENEX FOUNDATION, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:970-871-9988
Mailing Address - Street 1:1625 MID VALLEY DR
Mailing Address - Street 2:SUITE 1-111
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-9010
Mailing Address - Country:US
Mailing Address - Phone:970-871-9988
Mailing Address - Fax:970-871-9933
Practice Address - Street 1:943 W 8TH DR
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-3110
Practice Address - Country:US
Practice Address - Phone:970-826-4100
Practice Address - Fax:970-826-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0188314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO21675830Medicaid
CO065384Medicare ID - Type Unspecified