Provider Demographics
NPI:1407285992
Name:LIFE'S AT HOME CARE LLC
Entity Type:Organization
Organization Name:LIFE'S AT HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-337-5160
Mailing Address - Street 1:4601 STATION HOUSE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-2511
Mailing Address - Country:US
Mailing Address - Phone:757-535-2343
Mailing Address - Fax:757-251-0013
Practice Address - Street 1:6763 BURBAGE LANDING CIR
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-3090
Practice Address - Country:US
Practice Address - Phone:757-535-2343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-05
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health