Provider Demographics
NPI:1831449347
Name:SENIOR LIVING SERVICES, INC.
Entity type:Organization
Organization Name:SENIOR LIVING SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:FAITH
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:601-849-2722
Mailing Address - Street 1:1116 FRANCES AVE NW
Mailing Address - Street 2:
Mailing Address - City:MAGEE
Mailing Address - State:MS
Mailing Address - Zip Code:39111-3476
Mailing Address - Country:US
Mailing Address - Phone:601-849-1920
Mailing Address - Fax:601-849-1950
Practice Address - Street 1:1116 FRANCES AVE NW
Practice Address - Street 2:
Practice Address - City:MAGEE
Practice Address - State:MS
Practice Address - Zip Code:39111-3476
Practice Address - Country:US
Practice Address - Phone:601-849-1920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS979310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility