Provider Demographics
NPI:1295580157
Name:SENIORS LA VIE, LLC
Entity type:Organization
Organization Name:SENIORS LA VIE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/ ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FREDERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:MAUREL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-263-2286
Mailing Address - Street 1:2780 DANA LOOP
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2780 DANA LOOP
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9510
Practice Address - Country:US
Practice Address - Phone:214-263-2286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-23
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care