Provider Demographics
NPI:1073066403
Name:SENIOR CARE OF WEST L.A. INCORPORATED
Entity Type:Organization
Organization Name:SENIOR CARE OF WEST L.A. INCORPORATED
Other - Org Name:SENIORS HELPING SENIORS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:LANCELLOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-283-8598
Mailing Address - Street 1:3665 HUGHES AVE APT 225
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-7522
Mailing Address - Country:US
Mailing Address - Phone:310-283-8598
Mailing Address - Fax:
Practice Address - Street 1:9415 CULVER BLVD
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2616
Practice Address - Country:US
Practice Address - Phone:310-283-8598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA194700118253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care