Provider Demographics
NPI:1902040082
Name:ENHANCED SENIOR LIVING, LLC
Entity Type:Organization
Organization Name:ENHANCED SENIOR LIVING, LLC
Other - Org Name:SENIORS HELPING SENIORS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:972-780-0811
Mailing Address - Street 1:500 QUICK SILVER DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-3680
Mailing Address - Country:US
Mailing Address - Phone:972-780-0811
Mailing Address - Fax:972-780-0811
Practice Address - Street 1:763 VILLAGE GREEN DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2209
Practice Address - Country:US
Practice Address - Phone:972-780-0811
Practice Address - Fax:972-780-0811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care