SENIORS CLUB (NPI# 1295951176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295951176 |
| Entity Type | Organization |
| Organization Name | SENIORS CLUB |
| Practice Address |
2653 Malcolm St Shreveport LA 71108-2720 |
| Practice Telephone | 3186350010 |
| Practice Fax Number | 3186358844 |
| Mailing Telephone | 3186350010 |
| Mailing Fax Number | 3186358844 |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2008-06-23 |
| Authorized Official Name | MRS. KAREN R. MCCOY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3186350010 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 2677 | LA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1560880 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417079526 | Seniors Club | Custodial Care Facility | 2653 Malcolm St, Shreveport, LA 71108-2720 | 2007-04-06 |
| 1487870366 | Seniors Club | Custodial Care Facility | 2653 Malcolm St, Shreveport, LA 71108-2720 | 2007-04-18 |
| Street Address |
2653 MALCOLM ST |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71108-2720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417079526 | Seniors Club | Custodial Care Facility | 2653 Malcolm St, Shreveport, LA 71108-2720 | 2007-04-06 |
| 1487870366 | Seniors Club | Custodial Care Facility | 2653 Malcolm St, Shreveport, LA 71108-2720 | 2007-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528551140 | Berkelia Player | Case Manager/Care Coordinator | 8108 Kingston Road Suite 101 B, Shreveport, LA 71108 | 2018-06-08 |
| 1548757305 | Kenya Cawthorne | Counselor | 1520 Oakdale St, Shreveport, LA 71108 | 2018-04-17 |
| 1083112890 | Chantanell Johns | Case Manager/Care Coordinator | 8101 Kingston Rd Ste 101b, Shreveport, LA 71108 | 2018-01-26 |
| 1912425935 | Mildred Rivers | Case Manager/Care Coordinator | 4718 Hearne Ave, Shreveport, LA 71108 | 2017-08-30 |
| 1790205326 | Britney Ashton | Case Manager/Care Coordinator | 1910 Hickory St, Shreveport, LA 71108 | 2017-06-24 |
| 1548792674 | La'travia Jackson | Case Manager/Care Coordinator | 3430 Fernwood Ln, Shreveport, LA 71108 | 2017-03-29 |
| 1962941476 | Johnetta Marshall | Counselor | 6901 Despot Rd, Shreveport, LA 71108 | 2017-02-16 |
| 1295283992 | Shaun Cooper | Case Manager/Care Coordinator | 8824 Ruth Ave, Shreveport, LA 71108 | 2016-09-12 |
| 1508313735 | Tara Black | Counselor | 7019 Louise St, Shreveport, LA 71108 | 2016-09-06 |
| 1659828960 | Maranda Bolden | Counselor | 4906 Merlin Circle, Apt 4906, Shreveport, LA 71108 | 2016-09-02 |
| Find all providers in zip 71108 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376806430 | Youree Associates Inc. | Nursing Facility/Intermediate Care Facility | 5506 Camelot Dr, Shreveport, LA 71107-9558 | 2012-06-22 |
| 1306101035 | Youree Associates Inc. | Nursing Facility/Intermediate Care Facility | 5506 Camelot Dr, Shreveport, LA 71107-9558 | 2012-07-09 |
| 1568725620 | Youree Associates Inc | Nursing Facility/Intermediate Care Facility | 5506 Camelot Dr, Shreveport, LA 71107-9558 | 2012-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669929212 | Tender Care Adult Day Care | Nursing Facility/Intermediate Care Facility | 1501 Maura Pl, New Orleans, LA 70131-7912 | 2016-09-01 |
| 1780098798 | Royal Nursing Services, Inc | Nursing Facility/Intermediate Care Facility | 3510 Sugar Mill Rd, New Iberia, LA 70563-8621 | 2014-06-17 |
| 1538438015 | Tass Brain Injury Rehabilitation Center | Nursing Facility/Intermediate Care Facility | 42215 Pleasant Rg Ext, Ponchatoula, LA 70454-4723 | 2011-12-29 |
| 1497988380 | Opelousas Healthcare Properties LLC | Nursing Facility/Intermediate Care Facility | 7941 I-49 S Service Rd, Opelousas, LA 70570-9003 | 2009-08-26 |
| 1144463407 | Northridge Care Center LLC | Nursing Facility/Intermediate Care Facility | 3612 Baker Blvd, Baker, LA 70714-2513 | 2009-04-15 |
| 1457559023 | Paradise Adhc | Nursing Facility/Intermediate Care Facility | 2121 Dulles Rd, Lafayette, LA 70506 | 2007-07-05 |
| 1114123510 | Colette's Nursing & Healthcare | Nursing Facility/Intermediate Care Facility | 2100 3rd St, Suite#9, Kenner, LA 70062-7600 | 2007-06-22 |
| 1639383367 | Active Adult Day Healthcare LLC | Nursing Facility/Intermediate Care Facility | 333 E Prudhomme St, Opelousas, LA 70570-6490 | 2007-05-10 |
| 1437378908 | Louisiana Special Education Center | Nursing Facility/Intermediate Care Facility | 100 Pecan Loop, Alexandria, LA 71303-3753 | 2007-04-24 |
| 1043434715 | Association of Retarded Citizens of Evangeline, Inc | Nursing Facility/Intermediate Care Facility | 310 Northwest Railroad St, Ville Platte, LA 70586 | 2007-04-12 |
| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71108 |
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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.