Provider Demographics
NPI:1982214896
Name:1ST SENIORS LLC
Entity Type:Organization
Organization Name:1ST SENIORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CARE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:574-344-9916
Mailing Address - Street 1:51535 STEEPLE CHASE CT
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-8302
Mailing Address - Country:US
Mailing Address - Phone:574-904-1585
Mailing Address - Fax:
Practice Address - Street 1:598 W CARMEL DR STE F
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-2667
Practice Address - Country:US
Practice Address - Phone:317-652-6175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1ST SENIORS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health