Senior Residences, Inc.

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

Legal business name

SENIOR RESIDENCES, INC.

Doing business as

Senior Residences, Inc. -Dogwood Inn

Practice address

108 Wagner Rd
Bonifay, FL 32425-2923

Phone

(850) 547-3891

Fax

(850) 547-0177

NPI assigned

Mar 22, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Audrey Sims

Title

Executive Director

Phone

(850) 547-3891

Specialties & licenses 1

Addresses

Other names 1

• Senior Residences, Inc. -Dogwood Inn Doing business as

Locations

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013033661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 COLUMBIA RD",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272934",
            "telephone_number": "617-268-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 WAGNER RD",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324252923",
            "telephone_number": "850-547-3891",
            "fax_number": "850-547-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR RESIDENCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "850-547-3891"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Senior Residences, Inc. -Dogwood Inn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Penny L. Raley
• Robert E Pierce DMD PC
• Robert E Pierce, DMD, PC
• Patricia Rudd
• Gregory Sallas
• Rhonda L Serpas, LMT
• Sherrouse Psychiatry and Wellness
• Kayla Renae Sherrouse, ARNP
• Tiszon Sketo
• Marietta Elise Solomon, APRN

• Custodial Care Facility in Bonifay, FL
• Providers in Bonifay, FL by specialty
• Custodial Care Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.