Provider Demographics
NPI:1215703707
Name:SENIOR LIFESTYLE SOLUTIONS, LTD.
Entity type:Organization
Organization Name:SENIOR LIFESTYLE SOLUTIONS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:TEATOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-534-1608
Mailing Address - Street 1:282 MEMORIAL CT STE A
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-6277
Mailing Address - Country:US
Mailing Address - Phone:815-345-1608
Mailing Address - Fax:
Practice Address - Street 1:282 MEMORIAL CT STE A
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-6277
Practice Address - Country:US
Practice Address - Phone:815-534-1608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SENIOR LIFESTYLE SOLUTIONS, LTD.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-27
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health