Provider Demographics
NPI:1972806065
Name:5LIFE VENTURES, INC.
Entity type:Organization
Organization Name:5LIFE VENTURES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HO-CASTANEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-233-0702
Mailing Address - Street 1:370 AMAPOLA AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-7242
Mailing Address - Country:US
Mailing Address - Phone:424-233-0702
Mailing Address - Fax:424-217-1075
Practice Address - Street 1:370 AMAPOLA AVE STE 209
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-7242
Practice Address - Country:US
Practice Address - Phone:424-233-0702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-10
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care