Healthcare Provider Details
I. General information
NPI: 1013142033
Provider Name (Legal Business Name): LIFE POINT SENIOR SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/19/2009
Last Update Date: 01/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3885 S DECATUR BLVD SUITE 2010
LAS VEGAS NV
89103-5855
US
IV. Provider business mailing address
3885 S DECATUR BLVD SUITE 2010
LAS VEGAS NV
89103-5855
US
V. Phone/Fax
- Phone: 702-646-3805
- Fax: 702-646-3807
- Phone: 702-646-3805
- Fax: 702-646-3807
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 305S00000X |
| Taxonomy | Point of Service |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHATTY
BECKER
Title or Position: SECRETARY
Credential:
Phone: 702-646-3805