Senior Resource Association, Inc

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

SENIOR RESOURCE ASSOCIATION, INC

Practice address

815 Davis St
Sebastian, FL 32958-3842

Phone

(772) 569-0760

Fax

(772) 388-6130

NPI assigned

Jun 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Karen Deigl

Title

Ceo

Phone

(772) 569-0760

Specialties & licenses 4

Addresses

Other identifiers 4

Other names 2

• Council on Aging of IRC Former legal business name
• SENIOR RESOURCE ASSN., INC. Other name

Tax ID family

Council on Aging of Irc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Senior Resource Association, Inc

  • Adult Day Care Clinic/Center
  • Vero Beach, FL, FL
  • NPI 1881966646
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1003012089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "694 14TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605770",
            "telephone_number": "772-569-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 DAVIS ST",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583842",
            "telephone_number": "772-569-0760",
            "fax_number": "772-388-6130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "686 14TH STREET",
            "address_purpose": "LOCATION",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "32960",
            "country_code": "US",
            "telephone_number": "772-569-0760 x114",
            "fax_number": "772-778-7272",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "694 14th St",
            "address_purpose": "LOCATION",
            "city": "Vero Beach",
            "state": "FL",
            "postal_code": "329605770",
            "country_code": "US",
            "telephone_number": "772-569-0760 x104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SENIOR RESOURCE ASSOCIATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-22",
        "status": "A",
        "authorized_official_last_name": "DEIGL",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "772-569-0760"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087748401",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087748400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087748402",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087748403",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Council on Aging of IRC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "SENIOR RESOURCE ASSN., INC.",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SENIOR RESOURCE ASSN., INC.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sebastian Hospital LLC
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• Sebastian Internal Medicine Associates
• Sebastian Pathology Services
• Sebastian River Anesthesiology Associates, P. a.
• Arleene Michelle Sepulveda, M.T., ASCP, M.D.
• Shahbaaz A Shaikh, MD, FACC
• Hadi A Shalhoub, DO
• Gerges B Shanad
• Britney Shaw

• All providers in Sebastian, FL
• Adult Day Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.