Basic Information
| Provider Information | |||||||||
| NPI: | 1992729354 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SENIOR FRIENDSHIP CENTERS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2350 SCENIC DR | ||||||||
| Address2: | |||||||||
| City: | VENICE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342931510 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9415840036 | ||||||||
| FaxNumber: | 9414977195 | ||||||||
| Practice Location | |||||||||
| Address1: | 2355 STANFORD COURT UNIT 701 | ||||||||
| Address2: | SENIOR FRIENDSHIP HEALTH CENTER | ||||||||
| City: | NAPLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2395667425 | ||||||||
| FaxNumber: | 2395933430 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 07/12/2019 | ||||||||
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| AuthorizedOfficialLastName: | YINGLING | ||||||||
| AuthorizedOfficialFirstName: | LAURA | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9415840030 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM1300X | N | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | 261Q00000X | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.