Provider Demographics
NPI:1801449749
Name:AMERICAN SENIOR TRUST LLC
Entity type:Organization
Organization Name:AMERICAN SENIOR TRUST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CANELA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-501-8587
Mailing Address - Street 1:5129 NW 30TH LN
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3310
Mailing Address - Country:US
Mailing Address - Phone:754-701-8068
Mailing Address - Fax:
Practice Address - Street 1:5129 NW 30TH LN
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3310
Practice Address - Country:US
Practice Address - Phone:754-701-8068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-19
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health