Provider Demographics
NPI:1689925380
Name:LIFESTYLES HOME CARE, LLC
Entity Type:Organization
Organization Name:LIFESTYLES HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:HOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:863-602-8326
Mailing Address - Street 1:1591 HAYLEY LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-2121
Mailing Address - Country:US
Mailing Address - Phone:863-602-8326
Mailing Address - Fax:
Practice Address - Street 1:1591 HAYLEY LN
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-2121
Practice Address - Country:US
Practice Address - Phone:863-602-8326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health