Provider Demographics
NPI:1629379748
Name:SENIOR LIFESTYLE SERVICES, LLC.
Entity Type:Organization
Organization Name:SENIOR LIFESTYLE SERVICES, LLC.
Other - Org Name:COMFORCARE SENIOR SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MAXWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-380-0699
Mailing Address - Street 1:288 GROVE ST
Mailing Address - Street 2:SUITE 167
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-7209
Mailing Address - Country:US
Mailing Address - Phone:781-380-0699
Mailing Address - Fax:781-433-0083
Practice Address - Street 1:1 ADAMS PL
Practice Address - Street 2:SUITE 400
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-7482
Practice Address - Country:US
Practice Address - Phone:781-380-0699
Practice Address - Fax:781-433-0083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7235251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health