Senior Adult Services

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

SENIOR ADULT SERVICES

Practice address

409 N Springer St
Carbondale, IL 62901-1429

Phone

(618) 457-4151

NPI assigned

Jan 24, 2018

Last updated

Jan 24, 2018By 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

Henry Long

Title

Executive Director

Phone

(618) 457-4151

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1516752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516752000000",
    "number": "1023516044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 N SPRINGER ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011429",
            "telephone_number": "618-457-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 N SPRINGER ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011429",
            "telephone_number": "618-457-4151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR ADULT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-24",
        "last_updated": "2018-01-24",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "HENRY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-457-4151"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8694018",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcia Kate Scott, PA-C
• Quincy O Scott, D.O.
• Benjamin Scott Seed, D.C.
• Shelby Jo Seegers-Schafer, LCSW
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• Sensable Connections, PLLC
• Taylor Serrata
• Natasha Charlyn Shafer, FNP-BC
• Sonal Shah, M.D.
• Awni Darweesh Shahait, M.D.

• Adult Day Care Clinic/Center in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Adult Day Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.