Provider Demographics
NPI:1922127323
Name:LIFE SENIOR SERVICES, INC
Entity Type:Organization
Organization Name:LIFE SENIOR SERVICES, INC
Other - Org Name:ADULT DAY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-938-7606
Mailing Address - Street 1:5950 E 31ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-5114
Mailing Address - Country:US
Mailing Address - Phone:918-664-9000
Mailing Address - Fax:918-665-0830
Practice Address - Street 1:5950 E 31ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-5114
Practice Address - Country:US
Practice Address - Phone:918-664-9000
Practice Address - Fax:918-665-0830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKDC7204-7204261QA0600X
OKDC7211-7211261QA0600X
OKDC7210-7210261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100681690CMedicaid
OK100681690BMedicaid