Provider Demographics
NPI:1013142033
Name:LIFE POINT SENIOR SERVICES LLC
Entity Type:Organization
Organization Name:LIFE POINT SENIOR SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-646-3805
Mailing Address - Street 1:3885 S DECATUR BLVD
Mailing Address - Street 2:SUITE 2010
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-5855
Mailing Address - Country:US
Mailing Address - Phone:702-646-3805
Mailing Address - Fax:702-646-3807
Practice Address - Street 1:3885 S DECATUR BLVD
Practice Address - Street 2:SUITE 2010
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-5855
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:2009-05-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service