Organization
SENIOR THERAPY RESOURCES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA CEINSKI (OWNER)
(719) 322-5923
Entity
Organization
Contact information
Practice address
2921 WATERLEAF RD, JOHNS ISLAND, SC 29455-3176
(719) 322-5923
Mailing address
2921 WATERLEAF RD, JOHNS ISLAND, SC 29455-3176
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008120
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437459401
SOLE PROPRIETOR NPI
—
05
—
302589185001
—
IL
01
—
4532934
BLUE CROSS BLUE SHIELD OF ILLINOIS
IL
Enumeration date
06/15/2013
Last updated
03/09/2022
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