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General NPI Number Information
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NPI Number | 1073392692
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Entity Type | Organization
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Legal Business Name | SENIOR LIFECARE INC
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Dates
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Enumeration Date | 09/22/2023
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Last Update Date | 09/22/2023
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Provider Practice Location Address
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Address Line | 109 MEYER FARM RD
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City | ARNOLDSVILLE
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State | GA
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Zip | 30619-1532
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Country | US
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Telephone | 706-899-0321
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Fax |
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Provider Business Mailing Address
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Address Line | 2727 STOCKBRIDGE WAY
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City | DACULA
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State | GA
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Zip | 30019-7829
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Country | US
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Telephone | 708-376-0067
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AJARATU M AJANI
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Credential |
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Telephone | 770-837-6006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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