Provider Demographics
NPI:1821365958
Name:LIFESTYLE PERSONAL CARE SERVICE
Entity Type:Organization
Organization Name:LIFESTYLE PERSONAL CARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:DESMEIOUN
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALDRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-553-0277
Mailing Address - Street 1:9304 FOREST LN STE N271
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6238
Mailing Address - Country:US
Mailing Address - Phone:214-553-0277
Mailing Address - Fax:972-584-9905
Practice Address - Street 1:9304 FOREST LANE SUITE N271
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243
Practice Address - Country:US
Practice Address - Phone:214-553-0277
Practice Address - Fax:972-584-9905
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFESPAN RESOURCES OF TEXAS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care