Provider Demographics
NPI:1669135653
Name:LIFE SENIOR SERVICES, INC.
Entity type:Organization
Organization Name:LIFE SENIOR SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACT SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAWNYA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SLOAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-664-9000
Mailing Address - Street 1:5330 E 31ST ST STE 800
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-5004
Mailing Address - Country:US
Mailing Address - Phone:918-664-9000
Mailing Address - Fax:918-664-9922
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:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFE SENIOR SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health