Provider Demographics
NPI:1639485147
Name:SENIOR LIFE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:SENIOR LIFE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHATTY
Authorized Official - Middle Name:FERNANDEZ
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-646-3805
Mailing Address - Street 1:330 E TROPICANA AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-4225
Mailing Address - Country:US
Mailing Address - Phone:702-646-3805
Mailing Address - Fax:702-646-3807
Practice Address - Street 1:330 E TROPICANA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-4225
Practice Address - Country:US
Practice Address - Phone:702-646-3805
Practice Address - Fax:702-646-3807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-20
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service