Provider Demographics
NPI:1053446849
Name:SENIOR LIVING SYSTEMS INC.
Entity Type:Organization
Organization Name:SENIOR LIVING SYSTEMS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDEMUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-865-8813
Mailing Address - Street 1:PO BOX 7207
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87194-7207
Mailing Address - Country:US
Mailing Address - Phone:505-865-8813
Mailing Address - Fax:505-865-4866
Practice Address - Street 1:3216 STATE HIGHWAY 47
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-7544
Practice Address - Country:US
Practice Address - Phone:505-865-8813
Practice Address - Fax:505-865-4866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5399311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMD2525Medicaid
NM68107Medicaid