Healthcare Provider Details

I. General information

NPI: 1225815582
Provider Name (Legal Business Name): ATTENTIVE SENIOR CARE LLL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 W ATHENS AVE
CLOVIS CA
93611-3512
US

IV. Provider business mailing address

1829 S FAIRWAY AVE
FRESNO CA
93727-6218
US

V. Phone/Fax

Practice location:
  • Phone: 916-996-6215
  • Fax:
Mailing address:
  • Phone: 916-996-6215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: LAWRENCE C HOLLAND JR.
Title or Position: OWNER
Credential:
Phone: 916-996-6215