Provider Demographics
NPI:1477514743
Name:MYLIFE LLC
Entity Type:Organization
Organization Name:MYLIFE LLC
Other - Org Name:TEAM SELECT HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-382-8500
Mailing Address - Street 1:1420 KENSINGTON RD STE 106
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2144
Mailing Address - Country:US
Mailing Address - Phone:630-462-6700
Mailing Address - Fax:630-462-6703
Practice Address - Street 1:1420 KENSINGTON RD STE 106
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-2144
Practice Address - Country:US
Practice Address - Phone:630-462-6700
Practice Address - Fax:630-462-6703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
147903Medicare Oscar/Certification