Provider Demographics
NPI:1699310425
Name:ATTENTIVE SENIOR CARE 11, LLC
Entity type:Organization
Organization Name:ATTENTIVE SENIOR CARE 11, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:916-996-6215
Mailing Address - Street 1:1829 S FAIRWAY AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-6218
Mailing Address - Country:US
Mailing Address - Phone:916-996-6215
Mailing Address - Fax:559-540-7235
Practice Address - Street 1:6149 E LOWE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-5652
Practice Address - Country:US
Practice Address - Phone:559-515-6874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-15
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home