Provider Demographics
NPI:1487823894
Name:SENIOR CARE SPECIALISTS INC
Entity type:Organization
Organization Name:SENIOR CARE SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:K
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:970-330-8815
Mailing Address - Street 1:2320 43RD AVENUE CT
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-3810
Mailing Address - Country:US
Mailing Address - Phone:970-330-8815
Mailing Address - Fax:970-330-0202
Practice Address - Street 1:2320 43RD AVENUE CT
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-3810
Practice Address - Country:US
Practice Address - Phone:970-330-8815
Practice Address - Fax:970-330-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO81724363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO91123739Medicaid
COC518048Medicare PIN
CO91123739Medicaid