# SENIOR HEALTHCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639454044
- **Authorized official:** DANA E MORTON (ARNP)
- **Authorized official phone:** (316) 992-1591

## Contact information

- **Practice address:** 2921 W 1ST ST, COFFEYVILLE, KS 67337-2441
- **Practice address phone:** (620) 251-5190
- **Mailing address:** 302 SOUTHERN HILLS DR, COFFEYVILLE, KS 67337-9623
- **Mailing address phone:** (316) 992-1591

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 364SG0600X | Gerontology Clinical Nurse Specialist | 74308 | KS | Yes |

## Other

- **Enumeration date:** 10/17/2011
- **Last updated:** 10/17/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100447400A | — | KS |