Provider Demographics
NPI:1942581590
Name:SENIOR CARE SERVICES LLC
Entity type:Organization
Organization Name:SENIOR CARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:BERWANGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-991-0741
Mailing Address - Street 1:8373 PINEY ORCHARD PKWY STE 205
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-1531
Mailing Address - Country:US
Mailing Address - Phone:410-305-0888
Mailing Address - Fax:410-305-0777
Practice Address - Street 1:8373 PINEY ORCHARD PKWY STE 205
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1531
Practice Address - Country:US
Practice Address - Phone:410-305-0888
Practice Address - Fax:410-305-0777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2806251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health