Organization Name: | SENIOR LIFE MANAGEMENT, P.L.L.C. |
NPI Number: | 1396799557 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICHARD JUMAN (PRESIDENT) |
Mailing Address: | 1 Old Country Rd Suite 271 Carle Place |
State: | NY US |
Postal Code: | 115141801 |
Phone Number: | 8007256280 |
Fax Number: | 8007256380 |
NPI Enumeration Date: | 05/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |