Healthcare Provider Details

I. General information

NPI: 1396407649
Provider Name (Legal Business Name): LIFE SENIOR SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2021
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5950 E 31ST ST
TULSA OK
74135-5114
US

IV. Provider business mailing address

5330 E 31ST ST STE 800
TULSA OK
74135-5004
US

V. Phone/Fax

Practice location:
  • Phone: 918-664-9000
  • Fax: 918-664-9922
Mailing address:
  • Phone: 918-664-9000
  • Fax: 918-664-9922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. BILLY EARL COPELAND
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 918-664-9000