Provider Demographics
NPI:1225559891
Name:LIFETIME CARE, LLC
Entity Type:Organization
Organization Name:LIFETIME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:ISAAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-839-3772
Mailing Address - Street 1:5801 MARVIN D LOVE FWY STE 309
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-2318
Mailing Address - Country:US
Mailing Address - Phone:972-839-3772
Mailing Address - Fax:214-339-2216
Practice Address - Street 1:5801 MARVIN D LOVE FWY STE 309
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-2318
Practice Address - Country:US
Practice Address - Phone:972-839-3772
Practice Address - Fax:214-339-2216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251B00000XAgenciesCase Management
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities