Provider Demographics
NPI:1497371231
Name:1ST SENIORS LLC
Entity Type:Organization
Organization Name:1ST SENIORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CARE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:574-344-9916
Mailing Address - Street 1:51535 STEEPLE CHASE CT
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-8302
Mailing Address - Country:US
Mailing Address - Phone:574-904-1585
Mailing Address - Fax:
Practice Address - Street 1:3131 GRAPE RD
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-8834
Practice Address - Country:US
Practice Address - Phone:574-239-2273
Practice Address - Fax:574-239-7973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health