Seniorlife Therapy Clinic, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SENIORLIFE THERAPY CLINIC, INC

Practice address

4987 S Wildbrook Way
Boise, ID 83709-5279

Phone

(208) 841-7457

NPI assigned

Mar 24, 2009

Last updated

Mar 24, 2009By 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

Daniel A GragertNPI 1891161279

Title

Director

Phone

(208) 841-7457

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Gragert

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1891161279
  NPD Authorized official

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237852800000",
    "number": "1952543803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4987 S WILDBROOK WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837095279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4987 S WILDBROOK WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837095279",
            "telephone_number": "208-841-7457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIORLIFE THERAPY CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-24",
        "last_updated": "2009-03-24",
        "status": "A",
        "authorized_official_last_name": "GRAGERT",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "208-841-7457"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Semmler, LMFT
• Heidi Senethavilay, PHD, LPC
• Victoria Sengelmann, SLP
• Cheryl Anne Senieur
• Senior Care and Concierge
• Katiann N Senn, DPT
• Sonja Septon, DPT
• Willow Serafine, LMSW
• Matthew R Sericati, MD
• Catherine Devany Serio, PH.D.

• Physical Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; 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.