Provider Demographics
NPI:1265048540
Name:TOTAL LIFE CARE ASSIST LLC
Entity type:Organization
Organization Name:TOTAL LIFE CARE ASSIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:561-706-6624
Mailing Address - Street 1:4535 NW 6TH CT
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-2179
Mailing Address - Country:US
Mailing Address - Phone:561-706-6624
Mailing Address - Fax:
Practice Address - Street 1:4535 NW 6TH CT
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-2179
Practice Address - Country:US
Practice Address - Phone:561-706-6624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN1812182OtherFLORIDA DOH