MEDICARE: SENESCENCE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1609745660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENESCENCE LLC

Provider Business Mailing Address
First Line	:	4017 COMMON ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70607-2942
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4017 COMMON ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70607-2942
Country	:	US
Telephone Number	:	318-240-8515
Fax Number	:

Authorized Official
Title or Position	:	SECRETARY
Name	:	JAY KOEPER
Credential	:
Telephone Number	:	970-828-2210

Provider Enumeration Date	:	10/30/2025
Last Update Date	:	10/30/2025

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Directions to “SENESCENCE LLC ” Practice Location

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