Basic Information
| Provider Information | |||||||||
| NPI: | 1043652894 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SENIOR MATTERS EXTENDED CARE SERVICES, LLC | ||||||||
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| OtherOrganizationName: | ONE MATTERS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2711 MIDDLEBURG DR | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292042413 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2711 MIDDLEBURG DR | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 292042413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037651838 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2013 | ||||||||
| LastUpdateDate: | 10/10/2013 | ||||||||
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| AuthorizedOfficialLastName: | FUTCH | ||||||||
| AuthorizedOfficialFirstName: | HEATHER | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DIR. OF CASE MGMT. & NON-MED. SERVI | ||||||||
| AuthorizedOfficialTelephone: | 8037651838 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | SENIOR MATTERS EXTENDED CARE SERVICES, LLC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 372600000X | Y | 193400000X SINGLE SPECIALTY GROUP | Nursing Service Related Providers | Adult Companion |
No ID Information.