Provider Demographics
NPI:1194918326
Name:LIFE CARE HOME HEALTH SERVICES CORPORATION
Entity type:Organization
Organization Name:LIFE CARE HOME HEALTH SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-272-5866
Mailing Address - Street 1:13731 HICKMAN RD
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50323-2193
Mailing Address - Country:US
Mailing Address - Phone:515-267-0438
Mailing Address - Fax:515-267-0697
Practice Address - Street 1:13731 HICKMAN RD
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50323-2193
Practice Address - Country:US
Practice Address - Phone:515-267-0438
Practice Address - Fax:515-267-0697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health