Provider Demographics
NPI:1295337343
Name:SENIOR RESPECT, LLC
Entity type:Organization
Organization Name:SENIOR RESPECT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:MAPAGAY
Authorized Official - Last Name:TANCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-237-3177
Mailing Address - Street 1:4485 TENCH RD STE 510
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6740
Mailing Address - Country:US
Mailing Address - Phone:770-237-3177
Mailing Address - Fax:
Practice Address - Street 1:4485 TENCH RD STE 510
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6740
Practice Address - Country:US
Practice Address - Phone:770-237-3177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care