Organization Active NPI

Mid County Senior Services

  • Adult Day Care Clinic/Center
  • Broomall, PA
National Provider Identifier
1164581062
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
300140 Issued in PA
Legal business name
MID COUNTY SENIOR SERVICES
Practice address
1991 S Sprout Rd
Suite 850 Lawrence Park Adult Day Services
Broomall, PA 19008-3519
Phone
(610) 325-1600
Fax
(610) 325-1495
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Lesa Sulimay
Title
Executive Director
Phone
(610) 353-6642

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 300140 PA Primary

Addresses

Primary practice location

1991 S Sprout Rd
Suite 850 Lawrence Park Adult Day Services
Broomall, PA 19008-3519

Mailing address

22 Media Line Rd
Newtown Square, PA 19073-4601
Phone (610) 353-6642

Other identifiers 2

IdentifierTypeStateIssuer
1000058970003MedicaidPA
1000058970007MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Mid County Senior Services2 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.

Locations

22 Media Line Rd
Newtown Square, PA 19073

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164581062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 MEDIA LINE RD",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190734601",
            "telephone_number": "610-353-6642",
            "fax_number": "610-353-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 S SPROUT RD",
            "address_2": "SUITE 850 LAWRENCE PARK ADULT DAY SERVICES",
            "city": "BROOMALL",
            "state": "PA",
            "postal_code": "190083519",
            "telephone_number": "610-325-1600",
            "fax_number": "610-325-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID COUNTY SENIOR SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SULIMAY",
        "authorized_official_first_name": "LESA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "610-353-6642",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "PA",
            "license": "300140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000058970003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000058970007",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomall, PA

Sources for this page

  • 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.