1033551403 NPI number — SENIOR CARE GUIDANCE GROUP INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033551403 NPI number — SENIOR CARE GUIDANCE GROUP INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SENIOR CARE GUIDANCE GROUP INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033551403
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/19/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4200 FORBES BLVD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
LANHAM
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20706-4342
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-696-5522
Provider Business Mailing Address Fax Number:
301-263-7770

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4200 FORBES BLVD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
LANHAM
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20706-4342
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-696-5522
Provider Business Practice Location Address Fax Number:
301-263-7770
Provider Enumeration Date:
07/25/2013

Additional Information

Authorized Official

Authorized Official Last Name:
WAYS
Authorized Official First Name:
LETITIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
301-437-5551

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 071315900 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4235614 00 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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