Provider Demographics
NPI:1114283074
Name:LIFETIME SKILLS HOME HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:LIFETIME SKILLS HOME HEALTHCARE SERVICES
Other - Org Name:LSHS
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DIGEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BALLAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:267-975-6170
Mailing Address - Street 1:PO BOX 42763
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19101-2763
Mailing Address - Country:US
Mailing Address - Phone:215-365-2500
Mailing Address - Fax:215-365-2525
Practice Address - Street 1:2560 BONAFFON ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-2716
Practice Address - Country:US
Practice Address - Phone:267-975-6170
Practice Address - Fax:215-365-2525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health