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General NPI Number Information
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NPI Number | 1629379748
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Entity Type | Organization
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Legal Business Name | SENIOR LIFESTYLE SERVICES, LLC.
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 11/04/2010
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Provider Practice Location Address
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Address Line | 1 ADAMS PL SUITE 400
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City | QUINCY
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State | MA
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Zip | 02169-7482
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Country | US
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Telephone | 781-380-0699
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Fax | 781-433-0083
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Provider Business Mailing Address
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Address Line | 288 GROVE ST SUITE 167
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City | BRAINTREE
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State | MA
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Zip | 02184-7209
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Country | US
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Telephone | 781-380-0699
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Fax | 781-433-0083
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. STEVEN ROBERT MAXWELL
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Credential |
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Telephone | 781-380-0699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 7235
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License Number State | MA
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