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NPI Code Detail

MEDICARE: SENIOR LIFE ADVOCACY GROUP LLC.

MEDICARE: SENIOR LIFE ADVOCACY GROUP LLC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health AgencyNVS7744HHANV

General Provider Information

NPI Number : 1477940047
Entity Type Code : Organization
Provider Name (Legal Business Name) : SENIOR LIFE ADVOCACY GROUP LLC.
Provider Business Mailing Address
First Line : 1064 E SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-3220
Country : US
Telephone Number : 702-767-2881
Fax Number : 702-433-5789
Provider Business Practice Location Address
First Line : 1064 E SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-3220
Country : US
Telephone Number : 702-767-2881
Fax Number : 702-433-5789
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. FLORA SIWA-REYNOLDS
Credential : PHD
Telephone Number : 702-767-2881
Provider Enumeration Date : 04/22/2015
Last Update Date : 04/22/2015

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