Provider Demographics
NPI:1518668672
Name:REAL LIFE HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:REAL LIFE HOME CARE AGENCY LLC
Other - Org Name:REAL LIFE HOME CARE AGENCY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:RENAE
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-207-6120
Mailing Address - Street 1:2600 E SOUTH BLVD STE 238
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-2537
Mailing Address - Country:US
Mailing Address - Phone:334-593-0498
Mailing Address - Fax:334-593-0312
Practice Address - Street 1:2600 E SOUTH BLVD STE 238
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2537
Practice Address - Country:US
Practice Address - Phone:334-593-0498
Practice Address - Fax:334-593-0312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty