Provider Demographics
NPI:1093961765
Name:AGING IN PLACE ASSISTIVE SERVICES INC.
Entity Type:Organization
Organization Name:AGING IN PLACE ASSISTIVE SERVICES INC.
Other - Org Name:LIFEWELL ASSISTIVE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIKHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:GENERAL CONTRACTOR
Authorized Official - Phone:415-661-6650
Mailing Address - Street 1:2051 21ST AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-1208
Mailing Address - Country:US
Mailing Address - Phone:415-661-6650
Mailing Address - Fax:480-393-5023
Practice Address - Street 1:2051 21ST AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-1208
Practice Address - Country:US
Practice Address - Phone:415-661-6650
Practice Address - Fax:480-393-5023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA922291171W00000X, 171WH0202X, 171WV0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No171WV0202XOther Service ProvidersContractorVehicle ModificationsGroup - Multi-Specialty