Provider Demographics
NPI:1700122538
Name:AGEWAY SENIOR CARE INC.
Entity type:Organization
Organization Name:AGEWAY SENIOR CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DAYEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-363-0400
Mailing Address - Street 1:1162 FAY ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-2241
Mailing Address - Country:US
Mailing Address - Phone:650-363-0400
Mailing Address - Fax:
Practice Address - Street 1:1162 FAY ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061-2241
Practice Address - Country:US
Practice Address - Phone:650-363-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-26
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility