# SENIOR CARE SOURCE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Care Source Staffing
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811435126
- **Authorized official:** DANIELLE L. JACKSON RN (CEO)
- **Authorized official phone:** (386) 334-1476

## Contact information

- **Practice address:** 410 S. BEACH ST., SUITE 310, DAYTONA BEACH, FL 32114
- **Practice address phone:** (386) 334-1476
- **Practice address fax:** (386) 951-6449
- **Mailing address:** 410 S. BEACH ST., SUITE 310, DAYTONA BEACH, FL 32114
- **Mailing address phone:** (386) 334-1476
- **Mailing address fax:** (386) 951-6449

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251C00000X | Developmentally Disabled Services Day Training Agency | 234295 | FL | — |
| 253Z00000X | In Home Supportive Care Agency | 234295 | FL | Yes |

## Other

- **Enumeration date:** 02/07/2017
- **Last updated:** 02/07/2017