Provider Demographics
NPI:1477940047
Name:SENIOR LIFE ADVOCACY GROUP LLC.
Entity Type:Organization
Organization Name:SENIOR LIFE ADVOCACY GROUP LLC.
Other - Org Name:FLORAS HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLORA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIWA-REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:702-767-2881
Mailing Address - Street 1:1064 E SAHARA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-3220
Mailing Address - Country:US
Mailing Address - Phone:702-767-2881
Mailing Address - Fax:702-433-5789
Practice Address - Street 1:1064 E SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3220
Practice Address - Country:US
Practice Address - Phone:702-767-2881
Practice Address - Fax:702-433-5789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNVS7744HHA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health