Provider Demographics
NPI:1295080018
Name:HEALTHY SENIORS, LLC
Entity type:Organization
Organization Name:HEALTHY SENIORS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SHLAPAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-707-5030
Mailing Address - Street 1:2881 E OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE # 221
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1813
Mailing Address - Country:US
Mailing Address - Phone:954-707-5030
Mailing Address - Fax:
Practice Address - Street 1:2881 E OAKLAND PARK BLVD
Practice Address - Street 2:SUITE # 221
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1813
Practice Address - Country:US
Practice Address - Phone:954-707-5030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL229745OtherAGENCY FOR HEALTH CARE ADMINISTRATION