SENIORS CLUB (NPI# 1487870366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487870366 |
| 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 | 311Z00000X | Custodial Care Facility | 7392 | LA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1172596 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417079526 | Seniors Club | Custodial Care Facility | 2653 Malcolm St, Shreveport, LA 71108-2720 | 2007-04-06 |
| 1295951176 | Seniors Club | Nursing Facility/Intermediate 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 |
| 1295951176 | Seniors Club | Nursing Facility/Intermediate 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 | 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 |
|---|---|---|---|---|
| 1912186131 | Community Healthcare Solutions, L.l.c | Custodial Care Facility | 2500 Centenary Blvd Unit 11, Shreveport, LA 71104-2469 | 2007-10-25 |
| 1417079526 | Seniors Club | Custodial Care Facility | 2653 Malcolm St, Shreveport, LA 71108-2720 | 2007-04-06 |
| 1386789550 | Volunteers of America of North Louisiana | Custodial Care Facility | 360 Jordan St, Shreveport, LA 71101-4847 | 2007-02-21 |
| 1285850206 | Metropolitan Circles, LLC | Custodial Care Facility | 3510 Linwood Ave, Shreveport, LA 71103-4512 | 2007-04-18 |
| 1689706574 | Volunteers of America of North Louisiana | Custodial Care Facility | 360 Jordan St, Shreveport, LA 71101-4847 | 2007-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922659614 | Sarah Ronella Caldwell | Custodial Care Facility | 129 General Macarthur St, Lafayette, LA 70501-5135 | 2019-09-24 |
| 1245766005 | Neuro Rehabcare of Hammond, LLC | Custodial Care Facility | 41238 Adams Rd, Hammond, LA 70403-2069 | 2017-05-11 |
| 1548502834 | Caring Hands 2 PCa | Custodial Care Facility | 1520 Richwood Road 1, Monroe, LA 71202-6891 | 2013-03-25 |
| 1548554728 | Helping Hands for Healing Hearts LLC | Custodial Care Facility | 40377 Highway 190 E, Ste 200, Slidell, LA 70461-2522 | 2011-06-05 |
| 1093952723 | Saint Michael Health Care, LLC | Custodial Care Facility | 345 W Mills Ave, Breaux Bridge, LA 70517-4805 | 2009-01-16 |
| 1902073943 | Tender Love and Care Staffing Agency LLC | Custodial Care Facility | 11628 S Choctaw Dr Ste 219, Baton Rouge, LA 70815-2107 | 2008-05-09 |
| 1518135557 | Unlimited Care Services | Custodial Care Facility | 5487 Moulin Rouge Dr, Lake Charles, LA 70605-5283 | 2008-02-12 |
| 1487830568 | Good Shepherd Home Health | Custodial Care Facility | 2013 Oak Park Blvd Ste 101, Lake Charles, LA 70601-7833 | 2008-01-18 |
| 1932383908 | Jane Lockett Harman Outreach, Inc | Custodial Care Facility | 801 S Lewis St, Ste 3, New Iberia, LA 70560-4882 | 2007-12-26 |
| 1962681544 | Jane Lockett Hartman Outreach | Custodial Care Facility | 801 S Lewis St Ste 3, New Iberia, LA 70560-4882 | 2007-10-30 |
| 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.