Provider Demographics
NPI:1598162489
Name:SENIOR LIFE ADVOCACY GROUP LLC
Entity Type:Organization
Organization Name:SENIOR LIFE ADVOCACY GROUP LLC
Other - Org Name:F.L.O.R.A.S PERSONAL CARE ATTENDANT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FLORA
Authorized Official - Middle Name:G
Authorized Official - Last Name:SIWA
Authorized Official - Suffix:
Authorized Official - Credentials:
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:702-750-2209
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:702-750-2209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7761PCS-0253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care