Organization
SENIOR COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN WITHHART (CHIEF EXECUTIVE OFFICER)
(952) 541-1019
Entity
Organization
Contact information
Practice address
10709 WAYZATA BLVD, SUITE 111, MINNETONKA, MN 55305-5509
(952) 541-1019
(952) 541-0841
Mailing address
10709 WAYZATA BLVD, SUITE 111, MINNETONKA, MN 55305-5509
(952) 541-1019
(952) 541-0841
Taxonomy
Speciality
Code
Description
License number
State
347B00000X
Bus
Primary
153608
MN
Other
Enumeration date
09/02/2009
Last updated
09/02/2009
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