SENIOR RESIDENCES, INC. (NPI# 1013033661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013033661 |
| Entity Type | Organization |
| Organization Name | SENIOR RESIDENCES, INC. |
| Other Organization Name | SENIOR RESIDENCES, INC. -DOGWOOD INN |
| Practice Address |
108 Wagner Rd Bonifay FL 32425-2923 |
| Mailing Address |
1380 Columbia Rd South Boston MA 02127-2934 |
| Practice Telephone | 8505473891 |
| Practice Fax Number | 8505470177 |
| Mailing Telephone | 6172689061 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | AUDREY SIMS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8505473891 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311Z00000X | Custodial Care Facility | FL | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Senior Residences, Inc. -Dogwood Inn | Doing Business As Name - Organization |
| Street Address |
108 WAGNER RD |
| City | BONIFAY |
| State | FL |
| Zip Code | 32425-2923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649709528 | H & H Non Emergency Transportation Inc. | Non-emergency Medical Transport (VAN) | 108 Wagner Rd, Bonifay, FL 32425-2923 | 2017-06-05 |
| 1023400710 | Dogwood Inns Assisted Living Facility Inc | Assisted Living Facility | 108 Wagner Rd, Bonifay, FL 32425-2923 | 2015-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124650270 | Elizabeth H Lolley | Counselor | 1987 Remington Pl, Bonifay, FL 32425 | 2020-02-06 |
| 1891333274 | Traci Corbin | Registered Nurse | 603 Scenic Hill Circle, Bonifay, FL 32425 | 2019-12-16 |
| 1912339565 | Cb Health Ventures, Inc. | Assisted Living Facility | 108 Wagner Rd., Bonifay, FL 32425 | 2013-08-06 |
| 1558538868 | Patrick L Hawkins | Family Medicine | 3120 Southride Lane, Bonifay, FL 32425 | 2008-05-15 |
| 1477763860 | Pak Rural Health | Internal Medicine | 812 S. Weeks St, Bonifay, FL 32425 | 2007-05-23 |
| 1073680245 | Ahmad Tariq Ismail | Family Medicine | 110 East Byrd Ave, Bonifay, FL 32425 | 2006-11-30 |
| 1982775805 | County of Holmes Office Clerk Board of County Commissioners | Ambulance | 949 E. Hwy 90, Bonifay, FL 32425 | 2006-11-13 |
| 1710080890 | Bonifay Nsg & Rehab | Assisted Living Facility | 304 N Brock Ave, Bonifay, FL 32425 | 2006-09-06 |
| 1710949318 | Florida Department of Health | Public Health or Welfare | 603 Scenic Circle, Bonifay, FL 32425 | 2006-04-06 |
| 1366431702 | Holmes County Hospital Corporation | General Acute Care Hospital | 2600 Hospital Drive, Bonifay, FL 32425 | 2005-10-18 |
| Find all providers in zip 32425 | ||||
| Taxonomy Code | 311Z00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. |
| Notes: Source: Paraphrased from Section 3159 A3 of the Medicare Intermediary Manual. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184241804 | Assisted Living of Florida, Limited, Inc. | Custodial Care Facility | 10860 118th St, Seminole, FL 33778-3625 | 2020-06-29 |
| 1952936841 | Tequesta Dukes | Custodial Care Facility | 1713 W Marshall Lake Dr, Apopka, FL 32703-1622 | 2020-03-11 |
| 1881254712 | Claudette Paul | Custodial Care Facility | 4103 Day Bridge Pl, Ellenton, FL 34222-7236 | 2019-06-13 |
| 1366983140 | Medical Allied Nursing Academy, Inc. | Custodial Care Facility | 750 Plaza Orange Blossom Trail, Suite 264, Orlando, FL 32805 | 2017-03-14 |
| 1598204786 | Samantha Lamadieu | Custodial Care Facility | 709 S 51st St, Tampa, FL 33619-3703 | 2017-02-21 |
| 1578013033 | Aj Care Inc | Custodial Care Facility | 11990 Mellow Ct, West Palm Beach, FL 33411-9127 | 2016-10-09 |
| 1508225053 | Mccall Service, Inc. | Custodial Care Facility | 415 Nw 250th St, Suite 1, Newberry, FL 32669-4473 | 2016-02-12 |
| 1043679590 | Mccall Service, Inc. | Custodial Care Facility | 10211 E Columbus Dr, Tampa, FL 33619-7853 | 2016-02-12 |
| 1780043232 | Mccall Service, Inc. | Custodial Care Facility | 410 E Paul Russell Rd, Tallahassee, FL 32301-6960 | 2016-02-12 |
| 1588022909 | Brendlyn Assisted Living LLC | Custodial Care Facility | 81 Buttonworth Dr, Palm Coast, FL 32137-3507 | 2016-01-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.