Provider Demographics
NPI:1437462371
Name:LIVESTRONG HOME HEALTH
Entity Type:Organization
Organization Name:LIVESTRONG HOME HEALTH
Other - Org Name:SHELLEY AND PEREZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:214-803-2877
Mailing Address - Street 1:5218 VICKERY BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-6227
Mailing Address - Country:US
Mailing Address - Phone:214-803-2877
Mailing Address - Fax:
Practice Address - Street 1:5218 VICKERY BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-6227
Practice Address - Country:US
Practice Address - Phone:214-803-2877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1162509251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health