Provider Demographics
NPI:1104636471
Name:LIFORA HEALTH LLC
Entity type:Organization
Organization Name:LIFORA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASGOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-538-8190
Mailing Address - Street 1:13100 NOEL RD APT 308
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-0400
Mailing Address - Country:US
Mailing Address - Phone:813-538-8190
Mailing Address - Fax:
Practice Address - Street 1:13100 NOEL RD APT 308
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-0400
Practice Address - Country:US
Practice Address - Phone:813-538-8190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-09
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251E00000XAgenciesHome Health