Organization
SENIOR LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHENICIA SORRELS (OWNER)
(769) 203-1773
Entity
Organization
Contact information
Practice address
109 BELVA DR, VICKSBURG, MS 39180-8928
(769) 203-1773
Mailing address
109 BELVA DR, VICKSBURG, MS 39180-8928
(769) 203-1773
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
P320988
MS
Other
Enumeration date
04/19/2016
Last updated
04/19/2016
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