NPI 1013033661

Senior Residences, INC.

Organisation Custodial Care Facility Bonifay, FL

Practice location

Address: 108 Wagner Rd, Bonifay, FL 32425-2923
Phone: (850) 547-3891
Fax: (850) 547-0177
Mailing address: 1380 Columbia Rd, South Boston, MA 02127-2934

Authorised official

Name: Audrey Sims
Title: Executive Director
Phone: (850) 547-3891

Registered specialties

Custodial Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311Z00000X

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Registry record

NPI: 1013033661
Entity type: Organization
NPI issued: 22 Mar 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.