Provider Demographics
NPI:1659792935
Name:LAKE WEIR SENIOR SERVICES, LLC
Entity Type:Organization
Organization Name:LAKE WEIR SENIOR SERVICES, LLC
Other - Org Name:SENIORS HELPING SENIORS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-288-0444
Mailing Address - Street 1:PO BOX 77
Mailing Address - Street 2:
Mailing Address - City:EASTLAKE WEIR
Mailing Address - State:FL
Mailing Address - Zip Code:32133-0077
Mailing Address - Country:US
Mailing Address - Phone:352-288-0444
Mailing Address - Fax:
Practice Address - Street 1:13845 S HWY 25
Practice Address - Street 2:
Practice Address - City:EASTLAKE WEIR
Practice Address - State:FL
Practice Address - Zip Code:32133-0077
Practice Address - Country:US
Practice Address - Phone:352-288-0444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL232850253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care