NPIMap

Organization Active NPI

Community Seniorserv, Inc.

  • Home Delivered Meals
  • Anaheim, CA
National Provider Identifier
1780951632
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Delivered MealsTaxonomy code 332U00000X
License
BUS2007-04335 Issued in CA
Legal business name
COMMUNITY SENIORSERV, INC.
Practice address
1200 N Knollwood Cir
Anaheim, CA 92801-1309
Phone
(714) 220-0224
Fax
(714) 816-7397
NPI assigned
Nov 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Authorized official

Name
Mrs. Holly Hagler
Title
Ceo
Phone
(714) 220-0224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Delivered Meals 332U00000X BUS2007-04335 CA Primary

Addresses

Primary practice location

1200 N Knollwood Cir
Anaheim, CA 92801-1309

Mailing address

1200 N Knollwood Cir
Anaheim, CA 92801-1309
Phone (714) 220-0224

Other identifiers 2

IdentifierTypeStateIssuer
1770709305MedicaidCA
1710104344MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Community Seniorserv Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321833600000",
    "number": "1780951632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N KNOLLWOOD CIR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011309",
            "telephone_number": "714-220-0224",
            "fax_number": "714-816-7397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N KNOLLWOOD CIR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011309",
            "telephone_number": "714-220-0224",
            "fax_number": "714-816-7397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY SENIORSERV, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-21",
        "last_updated": "2011-11-21",
        "status": "A",
        "authorized_official_last_name": "HAGLER",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-220-0224",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": "CA",
            "license": "BUS2007-04335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770709305",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710104344",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; 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.