Provider Demographics
NPI:1891487500
Name:4LIFE HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:4LIFE HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ADELEYE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEKOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-909-5584
Mailing Address - Street 1:1106 N STATE HIGHWAY 360 STE 220
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-2511
Mailing Address - Country:US
Mailing Address - Phone:347-909-5584
Mailing Address - Fax:
Practice Address - Street 1:1106 N STATE HIGHWAY 360 STE 220
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-2511
Practice Address - Country:US
Practice Address - Phone:347-909-5584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care